Healthcare Provider Details

I. General information

NPI: 1780022046
Provider Name (Legal Business Name): JUDY J CURNOW LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2013
Last Update Date: 06/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 12TH STREET SUITE 10
ASTORIA OR
97103
US

IV. Provider business mailing address

1109 NW WARRENTON DR
WARRENTON OR
97146
US

V. Phone/Fax

Practice location:
  • Phone: 503-440-0101
  • Fax:
Mailing address:
  • Phone: 503-440-0101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number18715
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: