MEDICARE: RANDEE JEAN ANSHUTZ RDN, LD, 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	295547-00
2	133V00000X	Registered Dietitian	01030191
3	225700000X	Massage Therapist	7602	OR

General Provider Information

NPI Number	:	1619157898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANDEE JEAN ANSHUTZ RDN, LD, LMT

Provider Business Mailing Address
First Line	:	369 NE REVERE AVE STE 105
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97701-4082
Country	:	US
Telephone Number	:	541-323-3488
Fax Number	:	541-323-3483

Provider Business Practice Location Address
First Line	:	369 NE REVERE AVE STE 105
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97701-4082
Country	:	US
Telephone Number	:	541-323-3488
Fax Number	:	541-323-3483

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

Provider Enumeration Date	:	11/06/2007
Last Update Date	:	11/26/2025

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