MEDICARE: NICK FERBER

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	25226	OR

General Provider Information

NPI Number	:	1518598226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICK FERBER

Provider Business Mailing Address
First Line	:	PO BOX 3
Second Line	:
City	:	NEWPORT
State	:	OR
Zip	:	97365-0001
Country	:	US
Telephone Number	:	541-961-0799
Fax Number	:

Provider Business Practice Location Address
First Line	:	213 NE 11TH ST
Second Line	:
City	:	NEWPORT
State	:	OR
Zip	:	97365-3024
Country	:	US
Telephone Number	:	541-961-0799
Fax Number	:

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

Provider Enumeration Date	:	01/31/2020
Last Update Date	:	01/31/2020

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Directions to “ NICK FERBER ” Practice Location

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