Provider Demographics
NPI:1891843231
Name:DARLING, JENNIFER CLAIRE (LMT)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:CLAIRE
Last Name:DARLING
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3295 SW 106TH AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-1936
Mailing Address - Country:US
Mailing Address - Phone:503-317-4873
Mailing Address - Fax:
Practice Address - Street 1:3295 SW 106TH AVE
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-1936
Practice Address - Country:US
Practice Address - Phone:503-317-4873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR13113225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist