Boom, Jennifer Marie

Boom, Jennifer Marie is an individual health care provider with primary practice located at 24850 Se Stark St Suite 200, Gresham OR 97030-8316. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist, which is considered as her primary health care specialty. Boom, Jennifer Marie can be contacted via phone (503) 310-2622.

Contact Information

Primary practice address
24850 Se Stark St Suite 200 Gresham OR 97030-8316
Phone: (503) 310-2622
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist 225700000X 7615 Oregon

Profile Details

NPI number 1164547634
LBN Legal business name Boom, Jennifer Marie
Credentials LMT
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2007
Last updated Nov 9th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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