Individual
CATHY ANNE STALEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
459 SE 4TH ST, BEND, OR 97702-1653
(541) 390-5362
Mailing address
508 SE 4TH ST, BEND, OR 97702-1652
(541) 390-5362
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5708
OR
Other
Enumeration date
05/05/2015
Last updated
06/23/2015
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