Jennifer Mary Petesky, LMT

NPI #1982328878 in Dallas, Oregon

Provider Information

NPI Number: 1982328878
Entity Type: Individual
Name: Jennifer Mary Petesky, LMT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Massage Therapist
Credential: LMT
Enumeration Date: Oct 3, 2022
Last Updated: Oct 3, 2022

Practice Location

Address: 289 E ELLENDALE AVE STE 202
City: Dallas
State: Oregon
ZIP Code: 97338-1541
Phone: (503) 751-1460

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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