MEDICARE: RANDEE ANSHUTZ NUTRITION AND MASSAGE THERAPY

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	261QH0100X	Health Service Clinic/Center	1024	OR
2	261QH0100X	Health Service Clinic/Center	7602	OR

General Provider Information

NPI Number	:	1790020196
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RANDEE ANSHUTZ NUTRITION AND MASSAGE THERAPY

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	:	OWNER/OPERATOR
Name	:	RANDEE ANSHUTZ
Credential	:	RD, LD, NCTMB
Telephone Number	:	541-323-3488

Provider Enumeration Date	:	12/11/2012
Last Update Date	:	11/26/2025

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