Healthcare Provider Details

I. General information

NPI: 1235048745
Provider Name (Legal Business Name): BILLIE JEAN NEELY LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 NW 2ND AVE
CANBY OR
97013-3729
US

IV. Provider business mailing address

PO BOX 943
MOLALLA OR
97038-0943
US

V. Phone/Fax

Practice location:
  • Phone: 503-266-2997
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number7470
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: