Jennifer Marie Boom in Gresham - Massage Therapist
Jennifer Marie Boom - NPI 1164547634
Jennifer Marie Boom is a Massage Therapist in Gresham, Oregon. Jennifer Marie Boom practices all healthcare services and medical treatments related to Massage Therapist. The NPI Number for Jennifer Marie Boom is 1164547634. The last update date is 2016-11-09.
Jennifer Marie Boom's current location address is 24850 Se Stark St, Gresham, Oregon. You can contact this provider via phone number 5033102622. The mailing address for Jennifer Marie Boom is 24850 Se Stark St, Gresham, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jennifer Marie Boom |
|---|---|
| Address | 24850 Se Stark St, Gresham, Oregon |
| Phone Number | 5033102622 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | LMT |
NPI Number Detail
| NPI Number | 1164547634 |
|---|---|
| Provider Enumeration Date | 2007-03-21 |
| Last Updated Date | 2016-11-09 |
Provider Mailing Address Detail
| Address | 24850 Se Stark St |
|---|---|
| City | Gresham |
| State | Oregon (OR) |
| Post Code | 970308316 |
| Phone Number | 5033102622 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Massage Therapist |
|---|---|
| Taxonomy | 225700000X |
| Licence No | 7615 |
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Definition: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
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Post Comment/ Review Below
What is the Jennifer Marie Boom's 1164547634?
The Jennifer Marie Boom's NPI (National Provider Identifier) Number is 1164547634. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Jennifer Marie Boom?
The Jennifer Marie Boom is situated at 24850 Se Stark St, in the city of Gresham, state of OR, with the zip code 970308316.
What is Jennifer Marie Boom's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Jennifer Marie Boom's specialized field of practice is Massage Therapist, and the corresponding taxonomy code that categorizes this area of specialization is 225700000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1164547634 to Jennifer Marie Boom?
The Jennifer Marie Boom received its 1164547634 assignment from the Centers for Medicare & Medicaid Services on 2007-03-21.
When was the information related to Jennifer Marie Boom most recently updated or refreshed?
The details pertaining to the Jennifer Marie Boom, including its address, specialty, and other relevant information, were last updated or refreshed on 2016-11-09.