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General NPI Number Information
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NPI Number | 1174679971
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Entity Type | Individual
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Provider Name | SUZANNE SCHEVENE LMT
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Gender | Female
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 414 WASHINGTON ST 2B
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City | THE DALLES
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State | OR
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Zip | 97058-2262
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Country | US
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Telephone | 541-993-2847
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Fax |
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Provider Business Mailing Address
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Address Line | 811 W 11TH ST
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City | THE DALLES
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State | OR
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Zip | 97058-1121
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Country | US
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Telephone | 541-993-2847
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 9618
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA00007742
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License Number State | WA
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