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General NPI Number Information
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NPI Number | 1962803999
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Entity Type | Organization
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Legal Business Name | WATERSTONE SPA
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Dates
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Enumeration Date | 09/09/2014
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Last Update Date | 09/09/2014
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Provider Practice Location Address
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Address Line | 236 E MAIN ST
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City | ASHLAND
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State | OR
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Zip | 97520-1831
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Country | US
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Telephone | 541-488-0325
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Fax |
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Provider Business Mailing Address
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Address Line | 236 E MAIN ST
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City | ASHLAND
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State | OR
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Zip | 97520-1831
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Country | US
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Telephone | 541-488-0325
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Fax |
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Authorized Official
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Title or Position | SPA MANAGER
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Name | DEB CLELAND
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Credential | LMT
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Telephone | 541-488-0325
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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 | 15742
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 4717
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 7830
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 3271
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License Number State | OR
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Taxonomy #5
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 10040
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License Number State | OR
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Taxonomy #6
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 13277
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License Number State | OR
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Taxonomy #7
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 14949
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License Number State | OR
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Taxonomy #8
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 9081
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License Number State | OR
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Taxonomy #9
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 7728
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License Number State | OR
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Taxonomy #10
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 14893
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License Number State | OR
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Taxonomy #11
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 20191
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License Number State | OR
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Taxonomy #12
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 12260
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License Number State | OR
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Taxonomy #13
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 13700
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License Number State | OR
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Taxonomy #14
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 16600
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License Number State | OR
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Taxonomy #15
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 19945
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License Number State | OR
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