Provider Demographics
NPI:1508758913
Name:VANDEMARR, JASMINE DJANGO (LMT)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:DJANGO
Last Name:VANDEMARR
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 1:19917 QUAKING ASPEN AVE
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-8120
Mailing Address - Country:US
Mailing Address - Phone:503-544-7747
Mailing Address - Fax:
Practice Address - Street 1:2008 WILLAMETTE FALLS DR STE 200A
Practice Address - Street 2:
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-4673
Practice Address - Country:US
Practice Address - Phone:503-650-6494
Practice Address - Fax:541-585-1164
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR29024225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty