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General NPI Number Information
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NPI Number | 1508341793
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Entity Type | Individual
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Provider Name | AMY C KOWALSKI LMT
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Gender | Female
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Dates
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Enumeration Date | 10/03/2018
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 2542 NE COURTNEY DR.
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City | BEND
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State | OR
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Zip | 97701
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Country | US
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Telephone | 541-241-2127
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Fax | 541-460-7854
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Provider Business Mailing Address
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Address Line | 56 SE 11TH ST
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City | MADRAS
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State | OR
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Zip | 97741
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Country | US
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Telephone | 541-728-8453
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Fax | 541-460-7854
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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 | 23966
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License Number State | OR
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