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1225564016
JENNA BLACKHURST
BEAVERTON, OR
NPI
1225564016
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 22171)
Enumeration Date
2017-05-11
Last Update Date
2017-05-11
Business Address
-- JENNA BLACKHURST L.M.T.
11415 SW SCHOLLS FERRY RD
BEAVERTON, OR 97008-7168
Phone number: 541-261-6482
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Mailing Address
-- JENNA BLACKHURST L.M.T.
10914 SW 111TH AVE
TIGARD, OR 97223-3611
Phone number: 541-261-6482
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