| NPI | 1669827457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA JACKSON Manager 503-894-9730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OR 5848) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OR 5642) |
| 225700000X Massage Therapist (Licence: OR 12773) | |
| 225700000X Massage Therapist (Licence: OR 12936) | |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2017-10-21 |