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1083709950
JESSAMINE MICHELLE MAIBEN
HILLSBORO, OR
NPI
1083709950
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
156FC0800X Technician/Technologist Contact Lens
Enumeration Date
2006-10-04
Last Update Date
2007-07-08
Business Address
JESSAMINE MICHELLE MAIBEN
19400 NW EVERGREEN PKWY
HILLSBORO, OR 97124-7031
Phone number: 503-690-5005
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Mailing Address
JESSAMINE MICHELLE MAIBEN
906 CRESTVIEW DR
NEWBERG, OR 97132-1239
Phone number: 503-267-1347
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