Healthcare Provider Details

I. General information

NPI: 1538022629
Provider Name (Legal Business Name): JULIA ANNE DESKIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

461 NE GREENWOOD AVE
BEND OR
97701-4607
US

IV. Provider business mailing address

PO BOX 1166
BEND OR
97709-1166
US

V. Phone/Fax

Practice location:
  • Phone: 541-241-3135
  • Fax:
Mailing address:
  • Phone: 541-350-5765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number12104
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: