Healthcare Provider Details

I. General information

NPI: 1215433487
Provider Name (Legal Business Name): HANNAH RACHEL COMBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2018
Last Update Date: 04/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

656 CHARNELTON ST
EUGENE OR
97401-2689
US

IV. Provider business mailing address

996 W 4TH AVE APT 3
EUGENE OR
97402-4951
US

V. Phone/Fax

Practice location:
  • Phone: 541-653-8692
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number23985
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: