NPI 1003239104

Jackson Lee Andrews, LMT

Practitioner Massage Therapist Powell Butte, OR

Practice location

Address: 7380 SW Reif Rd, Powell Butte, OR 97753-1513
Phone: (541) 213-0491

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence 20031 (OR)

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Registry record

NPI: 1003239104
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Jan 2014
Record last updated: 24 Jan 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.