Individual
GEM MARIE TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.P
Contact information
Practice address
265 TANGENT ST, LEBANON, OR 97355-2728
(541) 974-8194
(541) 833-0906
Mailing address
265 TANGENT ST, LEBANON, OR 97355-2728
(541) 974-8194
(541) 833-0906
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
15086
OR
225700000X
Massage Therapist
MA00015257
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0158132
DEPT. OF LABOR AND INDUST
WA
Enumeration date
05/08/2007
Last updated
12/09/2020
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