Jennifer Eberly

Individual provider Active NPI Massage Therapist · Milwaukie, OR

NPI 1821399692 · NPPES record last updated Nov 10, 2010

Key facts

NPI
1821399692
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
14418 (OR)
Practice address
3716 SE International Way
Milwaukie, OR 97222-6001
Phone
(503) 659-0073
Fax
(503) 659-7471
NPI assigned
Nov 10, 2010
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
14418ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Keith D. Johns D.C., P.C. Past
since May 14, 2008
Accepting new patients
Milwaukie Chiropractic Center Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 14418 OR Yes

Addresses

Primary practice location

3716 SE International Way
Milwaukie, OR 97222-6001

Mailing address

6631 SE 48TH Ave
Portland, OR 97206-7616

Other providers in Milwaukie, OR

All providers in Milwaukie, OR · Massage Therapist in Oregon

Sources for this page

Verify at the official NPI Registry.