MEDICARE: VIRGINIA NOYES

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	20272	OR

General Provider Information

NPI Number	:	1922438548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIRGINIA NOYES

Provider Business Mailing Address
First Line	:	566 E ELLENDALE AVE
Second Line	:
City	:	DALLAS
State	:	OR
Zip	:	97338-3004
Country	:	US
Telephone Number	:	503-798-1962
Fax Number	:

Provider Business Practice Location Address
First Line	:	566 E ELLENDALE AVE
Second Line	:
City	:	DALLAS
State	:	OR
Zip	:	97338-3004
Country	:	US
Telephone Number	:	503-798-1962
Fax Number	:

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

Provider Enumeration Date	:	11/18/2013
Last Update Date	:	11/18/2013

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Directions to “ VIRGINIA NOYES ” Practice Location

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