MEDICARE: MRS. RENEE ESTES LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	3423	OR

General Provider Information

NPI Number	:	1144869777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RENEE ESTES LMT

Provider Business Mailing Address
First Line	:	1500 WASHINGTON AVE
Second Line	:
City	:	BAKER CITY
State	:	OR
Zip	:	97814-2815
Country	:	US
Telephone Number	:	541-524-1501
Fax Number	:

Provider Business Practice Location Address
First Line	:	1668 RESORT ST STE D
Second Line	:
City	:	BAKER CITY
State	:	OR
Zip	:	97814-3966
Country	:	US
Telephone Number	:	541-519-0146
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2019
Last Update Date	:	12/30/2019

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Directions to “ MRS. RENEE ESTES LMT” Practice Location

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