Individual
KATRINA GRUBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
628 NW YORK DR, BEND, OR 97703-1572
(541) 388-2429
Mailing address
1565 NW PORTLAND AVE APT 7, BEND, OR 97703-1400
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
24977
OR
Other
Enumeration date
04/08/2019
Last updated
04/08/2019
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