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NPI Code Detail

MEDICARE: MISS KRISTEN L BAUER LMP

MEDICARE: MISS KRISTEN L BAUER LMP
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
1225700000XMassage TherapistMA60373991WA

General Provider Information

NPI Number : 1083028658
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS KRISTEN L BAUER LMP
Provider Business Mailing Address
First Line : 14313 NE 20TH AVE
Second Line : SUITE A112
City : VANCOUVER
State : WA
Zip : 98686-1487
Country : US
Telephone Number : 360-574-9440
Fax Number : 360-574-9288
Provider Business Practice Location Address
First Line : 820 OCEAN BEACH HWY STE 120
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-4081
Country : US
Telephone Number : 360-414-3220
Fax Number : 360-353-5350
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2014
Last Update Date : 10/22/2024

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Directions to “ MISS KRISTEN L BAUER LMP” Practice Location

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