Healthcare Provider Details

I. General information

NPI: 1962363507
Provider Name (Legal Business Name): CASSIDY GEPPERT LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2025
Last Update Date: 11/22/2025
Certification Date: 11/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

346 FINDLEY RD
WILLIAMS OR
97544-2502
US

IV. Provider business mailing address

PO BOX 535
WILLIAMS OR
97544-0535
US

V. Phone/Fax

Practice location:
  • Phone: 541-846-8505
  • Fax:
Mailing address:
  • Phone: 541-846-8505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number29190
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: