MEDICARE: CANDACE MADELINE ANDERSON LMT

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	29325	OR

General Provider Information

NPI Number	:	1598623977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CANDACE MADELINE ANDERSON LMT

Provider Business Mailing Address
First Line	:	2210 SUNNYDALE DR
Second Line	:
City	:	THE DALLES
State	:	OR
Zip	:	97058-9573
Country	:	US
Telephone Number	:	405-385-2938
Fax Number	:

Provider Business Practice Location Address
First Line	:	508 WASHINGTON ST UNIT 11
Second Line	:
City	:	THE DALLES
State	:	OR
Zip	:	97058-2232
Country	:	US
Telephone Number	:	541-249-9816
Fax Number	:

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

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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Directions to “ CANDACE MADELINE ANDERSON LMT” Practice Location

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