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1982937140
JAYDE THEOBALD
PORTLAND, OR
NPI
1982937140
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 16457)
Enumeration Date
2009-09-04
Last Update Date
2014-10-30
Business Address
MS. JAYDE THEOBALD LMT
4642 SE MADISON ST
PORTLAND, OR 97215-2572
Phone number: 503-313-6626
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Mailing Address
MS. JAYDE THEOBALD LMT
4642 SE MADISON ST
PORTLAND, OR 97215-2572
Phone number: 503-313-6626
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