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1952589129
TRISTA L. JOLLY
PORTLAND, OR
NPI
1952589129
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171100000X Acupuncturist
(Licence: OR AC01171)
Enumeration Date
2008-02-09
Last Update Date
2008-02-09
Business Address
-- TRISTA L. JOLLY MAOM, L.Ac.
3234 NE WASCO ST
PORTLAND, OR 97232-1981
Phone number: 503-703-3197
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Mailing Address
-- TRISTA L. JOLLY MAOM, L.Ac.
1142 SE 52ND AVE
PORTLAND, OR 97215-2633
Phone number: 503-703-3197
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