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General NPI Number Information
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NPI Number | 1376934414
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Entity Type | Individual
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Provider Name | TRESSA GLASER LMT
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Gender | Female
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Dates
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Enumeration Date | 02/11/2015
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Last Update Date | 02/11/2015
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Provider Practice Location Address
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Address Line | 317 1ST AVE W SUITE 101
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City | ALBANY
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State | OR
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Zip | 97321-2225
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Country | US
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Telephone | 541-231-7841
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Fax |
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Provider Business Mailing Address
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Address Line | 271 S 3RD ST
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City | LEBANON
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State | OR
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Zip | 97355-2706
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Country | US
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Telephone | 541-231-7841
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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 | 16424
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License Number State | OR
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