Individual
AMANDA LOUISE WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
516 SW 13TH ST STE 102, BEND, OR 97702-3442
(541) 728-0689
(541) 728-0815
Mailing address
516 SW 13TH ST STE 102, BEND, OR 97702-3442
(541) 728-0689
(541) 728-0815
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
24371
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24371
MASSAGE THERAPY LICENSE
OR
Enumeration date
12/19/2018
Last updated
12/19/2018
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