Individual provider · Type 1 NPI

Jennifer Marie Boom, LMT

Massage Therapist · Gresham, OR

NPI number 1164547634 Active

Practice location

24850 SE Stark St, Suite 200
Gresham, OR 97030-8316

Call (503) 310-2622 Map

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X7615 (OR)

Massage Therapist: 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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About NPI 1164547634

Jennifer Marie Boom, LMT's National Provider Identifier is 1164547634, issued on Mar 21, 2007. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Gresham, OR. The record was last updated on Nov 9, 2016.