MEDICARE: HAYLEY MARIE STORMS 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	24565	OR

General Provider Information

NPI Number	:	1588131494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAYLEY MARIE STORMS LMT

Provider Business Mailing Address
First Line	:	895 COUNTRY CLUB RD STE A140
Second Line	:
City	:	EUGENE
State	:	OR
Zip	:	97401-6028
Country	:	US
Telephone Number	:	541-543-0572
Fax Number	:

Provider Business Practice Location Address
First Line	:	895 COUNTRY CLUB RD STE A140
Second Line	:
City	:	EUGENE
State	:	OR
Zip	:	97401-6028
Country	:	US
Telephone Number	:	541-543-0572
Fax Number	:	541-228-5158

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

Provider Enumeration Date	:	10/29/2018
Last Update Date	:	10/29/2018

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