Individual
MISS NATASHA DAUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1110 18TH ST, SPRINGFIELD, OR 97477-4200
(541) 297-0182
Mailing address
1110 18TH ST, SPRINGFIELD, OR 97477-4200
(541) 297-0182
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
15902
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15902
LMT
OR
Enumeration date
11/16/2017
Last updated
03/17/2018
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