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General NPI Number Information
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NPI Number | 1336577709
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Entity Type | Individual
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Provider Name | ZELLENE STRUBLE CPM, LMT
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Gender | Female
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Dates
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Enumeration Date | 10/23/2013
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Last Update Date | 09/19/2024
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Provider Practice Location Address
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Address Line | 421 DAVIDSON RD
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City | WILLIAMS
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State | OR
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Zip | 97544-9604
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Country | US
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Telephone | 240-285-4223
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 554
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City | WILLIAMS
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State | OR
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Zip | 97544-0554
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Country | US
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Telephone | 240-285-4223
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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 | 2004-1417
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number | 111058
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 0129000089
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | DEM-LD-10241653
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License Number State | OR
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Taxonomy #5
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 26626
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License Number State | OR
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