Healthcare Provider Details

I. General information

NPI: 1821918657
Provider Name (Legal Business Name): BRIANNA CAMP, LMT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

446 E ST
SPRINGFIELD OR
97477-3967
US

IV. Provider business mailing address

446 E ST
SPRINGFIELD OR
97477-3967
US

V. Phone/Fax

Practice location:
  • Phone: 541-513-9879
  • Fax:
Mailing address:
  • Phone: 541-513-9879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: BRIANNA ODESSA CAMP
Title or Position: OWNER AND LICENSED MASSAGE THERAPIS
Credential:
Phone: 541-513-9879