Individual provider · Type 1 NPI

Diane Michelle Jensen-Rucker, LMT

Specialist · Portland, OR

NPI number 1629140884 Active

Practice location

2330 NW Flanders St, Suite 205
Portland, OR 97210-3442

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000X7404 (OR)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1629140884

Diane Michelle Jensen-Rucker, LMT's National Provider Identifier is 1629140884, issued on Nov 14, 2006. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Portland, OR. The record was last updated on Jul 8, 2007.