Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | L6109 | OR |
N | 225700000X | Massage Therapist | 14673 | OR |
NPI | 1013247998 |
---|---|
Provider Name | Savoy Rose Jade |
First Address | Newport, OR 97365-0152 |
Second Address | Newport, OR 97365-2357 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2009 |
Last Update Date | 30/04/2015 |