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General NPI Number Information
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NPI Number | 1215840541
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Entity Type | Individual
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Provider Name | COLLEEN NOEL HEISEY LMT
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Gender | Female
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Dates
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Enumeration Date | 09/26/2026
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Last Update Date | 09/26/2026
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Provider Practice Location Address
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Address Line | 1011 SW EMKAY DR
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City | BEND
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State | OR
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Zip | 97702-3162
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Country | US
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Telephone | 541-610-6057
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Fax |
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Provider Business Mailing Address
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Address Line | 23 MEADOW HILLS LN
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City | ELMA
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State | WA
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Zip | 98541-9495
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Country | US
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Telephone | 360-701-9555
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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 | 29383
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License Number State | OR
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