MEDICARE: MRS. TIFFANY ANN CLARKIN L.M.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	5022	OR

General Provider Information

NPI Number	:	1063553147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TIFFANY ANN CLARKIN L.M.T.

Provider Business Mailing Address
First Line	:	119 TERRACE OAKS LN
Second Line	:
City	:	MERLIN
State	:	OR
Zip	:	97532-9744
Country	:	US
Telephone Number	:	541-474-2334
Fax Number	:

Provider Business Practice Location Address
First Line	:	119 TERRACE OAKS LN
Second Line	:
City	:	MERLIN
State	:	OR
Zip	:	97532-9744
Country	:	US
Telephone Number	:	541-474-2334
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2007
Last Update Date	:	07/08/2007

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Directions to “ MRS. TIFFANY ANN CLARKIN L.M.T.” Practice Location

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