Healthcare Provider Details

I. General information

NPI: 1891978680
Provider Name (Legal Business Name): VALERIE CHRISTINE WILLMAN L.M.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2007
Last Update Date: 06/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 CHARNELTON ST
EUGENE OR
97401-2937
US

IV. Provider business mailing address

1741 WILSON ST
EUGENE OR
97402-3354
US

V. Phone/Fax

Practice location:
  • Phone: 541-521-3711
  • Fax:
Mailing address:
  • Phone: 541-521-3711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number12969
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: