MEDICARE: DEBORAH LYNN BALSER LMP

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	MA00009632	WA

General Provider Information

NPI Number	:	1366590994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH LYNN BALSER LMP

Provider Business Mailing Address
First Line	:	2530 DEER PARK RD
Second Line	:
City	:	PORT ANGELES
State	:	WA
Zip	:	98362-8269
Country	:	US
Telephone Number	:	360-452-8145
Fax Number	:

Provider Business Practice Location Address
First Line	:	1215 E 1ST ST STE E
Second Line	:
City	:	PORT ANGELES
State	:	WA
Zip	:	98362-4323
Country	:	US
Telephone Number	:	360-452-8145
Fax Number	:	360-452-8145

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

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	10/03/2024

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