Individual
LINDA RUTH HEISSERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
125 NW GREELEY AVE, BEND, OR 97701-2913
(541) 388-4589
Mailing address
2264 NW WEST HILLS AVE, BEND, OR 97701-1047
(541) 389-0934
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LMT 2451
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LMT 2451
MASSAGE THERAPY LICENSE
OR
Enumeration date
03/26/2007
Last updated
07/08/2007
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