Individual
LAKEN ELAINE BUSSARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
447 NE GREENWOOD AVE, BEND, OR 97701-4607
(541) 213-0933
Mailing address
20894 NOVA LOOP UNIT 1, BEND, OR 97701-4080
(614) 813-3842
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
27111
OR
Other
Enumeration date
10/12/2022
Last updated
10/12/2022
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