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NPI Code Detail

MEDICARE: MRS. DEE YOUNGQUIST LMT

MEDICARE: MRS. DEE YOUNGQUIST 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
1225700000XMassage Therapist19461OR

General Provider Information

NPI Number : 1578993564
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DEE YOUNGQUIST LMT
Provider Business Mailing Address
First Line : 19788 ASTRO PL
Second Line :
City : BEND
State : OR
Zip : 97702-2999
Country : US
Telephone Number : 503-367-2869
Fax Number :
Provider Business Practice Location Address
First Line : 222 SE URANIA LN
Second Line :
City : BEND
State : OR
Zip : 97702-1624
Country : US
Telephone Number : 503-367-2869
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2013
Last Update Date : 11/12/2013

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Directions to “ MRS. DEE YOUNGQUIST LMT” Practice Location

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