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General NPI Number Information
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NPI Number | 1912722158
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Entity Type | Individual
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Provider Name | CINNAMON CRABB LMT
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Gender | Female
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 369 NE REVERE AVE STE 105
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City | BEND
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State | OR
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Zip | 97701-4082
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Country | US
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Telephone | 541-323-3488
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Fax |
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Provider Business Mailing Address
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Address Line | 62920 CLYDE LN
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City | BEND
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State | OR
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Zip | 97701-9755
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Country | US
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Telephone | 213-281-4099
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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 | 26599
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License Number State | OR
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