Healthcare Provider Details

I. General information

NPI: 1689602963
Provider Name (Legal Business Name): SYLVIA WILLIAMSON L.M.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 ELM ST SW
ALBANY OR
97321-2063
US

IV. Provider business mailing address

821 ELM ST SW
ALBANY OR
97321-2063
US

V. Phone/Fax

Practice location:
  • Phone: 541-928-5590
  • Fax: 541-924-9943
Mailing address:
  • Phone: 541-928-5590
  • Fax: 541-924-9943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number6753
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: