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General NPI Number Information
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NPI Number | 1912416694
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Entity Type | Organization
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Legal Business Name | HANDS OF DAWN LLC
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Dates
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Enumeration Date | 09/25/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 250 PRINCETON AVE STE 207B
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City | GLADSTONE
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State | OR
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Zip | 97027-2566
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Country | US
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Telephone | 503-567-4263
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Fax |
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Provider Business Mailing Address
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Address Line | 250 PRINCETON AVE STE 207B
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City | GLADSTONE
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State | OR
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Zip | 97027-2566
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Country | US
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Telephone | 503-567-4263
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Fax |
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Authorized Official
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Title or Position | OWNER/LMT
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Name | DAWN M JENSON
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Credential | LMT
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Telephone | 503-567-4263
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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 | 13546
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License Number State | OR
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