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General NPI Number Information
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NPI Number | 1194182972
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Entity Type | Organization
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Legal Business Name | MASSAGE SOLUTIONS OF BEND
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Dates
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Enumeration Date | 01/25/2016
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Last Update Date | 01/25/2016
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Provider Practice Location Address
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Address Line | 1289 NE 2ND ST STE 3
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City | BEND
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State | OR
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Zip | 97701-4372
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Country | US
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Telephone | 541-317-4826
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Fax | 541-797-2147
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Provider Business Mailing Address
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Address Line | 1289 NE 2ND ST STE 3
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City | BEND
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State | OR
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Zip | 97701-4372
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Country | US
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Telephone | 541-317-4826
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Fax | 541-797-2147
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Authorized Official
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Title or Position | OWNER
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Name | DORRAINE BUDKE
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Credential |
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Telephone | 541-420-6822
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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 | 5132
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License Number State | OR
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