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General NPI Number Information
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NPI Number | 1578704128
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Entity Type | Individual
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Provider Name | DIANE KAY STONE L.M.T.
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Gender | Female
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Dates
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Enumeration Date | 03/11/2009
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Last Update Date | 04/09/2013
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Provider Practice Location Address
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Address Line | 805 LIBERTY ST NE
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City | SALEM
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State | OR
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Zip | 97301-2463
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Country | US
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Telephone | 971-409-5292
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Fax |
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Provider Business Mailing Address
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Address Line | 925 KENARD CT NW
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City | SALEM
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State | OR
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Zip | 97304-2654
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Country | US
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Telephone | 971-409-5292
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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 | 15545
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License Number State | OR
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