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General NPI Number Information
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NPI Number | 1396183877
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Entity Type | Individual
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Provider Name | JENNIFER VANSCOYK LMT
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Gender | Female
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Dates
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Enumeration Date | 06/06/2013
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Last Update Date | 03/21/2019
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Provider Practice Location Address
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Address Line | 707 E 5TH ST
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City | MCMINNVILLE
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State | OR
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Zip | 97128-4508
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Country | US
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Telephone | 503-883-0099
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 NW ADAMS ST STE C
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City | MCMINNVILLE
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State | OR
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Zip | 97128-3550
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Country | US
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Telephone | 971-241-9870
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 19451
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License Number State | OR
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