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General NPI Number Information
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NPI Number | 1508758913
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Entity Type | Individual
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Provider Name | JASMINE DJANGO VANDEMARR LMT
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Gender | Female
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Dates
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Enumeration Date | 07/18/2025
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 2008 WILLAMETTE FALLS DR STE 200A
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City | WEST LINN
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State | OR
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Zip | 97068-4673
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Country | US
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Telephone | 503-650-6494
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Fax | 541-585-1164
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Provider Business Mailing Address
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Address Line | 19917 QUAKING ASPEN AVE
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City | OREGON CITY
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State | OR
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Zip | 97045-8120
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Country | US
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Telephone | 503-544-7747
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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 | 29024
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License Number State | OR
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