Healthcare Provider Details

I. General information

NPI: 1831307479
Provider Name (Legal Business Name): JENNIFER DAWN BUYS L.AC., L.M.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 12/07/2021
Certification Date: 12/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

927 NW GRANT AVENUE
CORVALLIS OR
97330-4503
US

IV. Provider business mailing address

7450 NW MOUNTAIN VIEW DR
CORVALLIS OR
97330-9753
US

V. Phone/Fax

Practice location:
  • Phone: 541-231-5282
  • Fax: 541-566-7592
Mailing address:
  • Phone: 541-231-5282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number6025
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC00482
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: