Individual
ELLYN SUE VANDENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2955 N HWY 97, BEND, OR 97703-7559
(541) 728-3004
Mailing address
63987 SUNSET DR, BEND, OR 97703-8590
(541) 280-5045
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5129
OR
Other
Enumeration date
12/26/2025
Last updated
12/26/2025
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