Healthcare Provider Details

I. General information

NPI: 1356161517
Provider Name (Legal Business Name): RAIN AUDEN LMT
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: DANIELLE AUDEN

II. Dates (important events)

Enumeration Date: 10/14/2024
Last Update Date: 10/14/2024
Certification Date: 10/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1663 HIGH ST
EUGENE OR
97401-4113
US

IV. Provider business mailing address

1380 LAWRENCE ST APT 2
EUGENE OR
97401-3183
US

V. Phone/Fax

Practice location:
  • Phone: 458-317-5725
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number28596
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: