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General NPI Number Information
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NPI Number | 1588469654
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Entity Type | Individual
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Provider Name | TARA LYNN LEPRO LMT
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Gender | Female
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Dates
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Enumeration Date | 02/13/2025
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 3400 SE 196TH AVE
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City | CAMAS
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State | WA
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Zip | 98607-8861
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Country | US
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Telephone | 503-660-8154
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Fax | 888-316-1430
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Provider Business Mailing Address
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Address Line | 18413 NE 184TH ST
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City | BRUSH PRAIRIE
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State | WA
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Zip | 98606-9757
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Country | US
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Telephone | 360-210-2276
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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 | 61582427
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License Number State | WA
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