Jae M Fairbanks, LMT

NPI #1316487622 in Clackamas, Oregon

Provider Information

NPI Number
1316487622
Entity Type
Individual
Name
Jae M Fairbanks, LMT
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Massage Therapist
Credential
LMT
Enumeration Date
Mar 6, 2017
Last Updated
Mar 6, 2017

Practice Location

Address
10001 SE SUNNYSIDE RD
Address 2
STE 220
State
Oregon
ZIP Code
97015-5746
Phone
(503) 908-0881

Specialties & Taxonomy Codes

Specialty
Massage Therapist

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