Individual provider · Type 1 NPI

Jae M. Fairbanks, LMT

Massage Therapist · Clackamas, OR

NPI number 1316487622 Active

Practice location

10001 SE Sunnyside Rd, Ste 220
Clackamas, OR 97015-5746

Call (503) 908-0881 Map

Fax (503) 908-0891

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X023062 (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 1316487622

Jae M. Fairbanks, LMT's National Provider Identifier is 1316487622, issued on Mar 6, 2017. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Clackamas, OR. The record was last updated on Mar 6, 2017.