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NPI Code Detail

MEDICARE: REBECCA O'BRIEN

MEDICARE: REBECCA O'BRIEN
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 Therapist22403OR

General Provider Information

NPI Number : 1871042945
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA O'BRIEN
Provider Business Mailing Address
First Line : 158 SE HEYBURN ST
Second Line :
City : BEND
State : OR
Zip : 97702-1312
Country : US
Telephone Number : 541-508-9392
Fax Number :
Provider Business Practice Location Address
First Line : 369 NE REVERE AVE
Second Line :
City : BEND
State : OR
Zip : 97701-4082
Country : US
Telephone Number : 458-206-0757
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2016
Last Update Date : 04/17/2018

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Directions to “ REBECCA O'BRIEN ” Practice Location

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