Healthcare Provider Details

I. General information

NPI: 1356469621
Provider Name (Legal Business Name): DEBBIE A DUNBAR LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1569 SW NANCY WAY STE L
BEND OR
97702-3234
US

IV. Provider business mailing address

20962 SE DESERT WOODS DR
BEND OR
97702-2845
US

V. Phone/Fax

Practice location:
  • Phone: 541-389-9560
  • Fax:
Mailing address:
  • Phone: 541-389-9560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number6040
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: