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NPI Profile for JAMIE D SHACKELFORD in TIGARD, OR.
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.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Massage Therapist |
225700000X | |||
Contractor |
171W00000X |
| NPI Number | 1689791394 |
|
| Status | Active | |
| Credentials | LMT (Licensed Massage Therapist) | |
| Entity | Individual | |
| Enumeration date | 03/26/2007 | |
| Last updated | 07/23/2013 - About 13 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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JAMIE D SHACKELFORD
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JAMIE D SHACKELFORD, LMT