Organization
BLESSED TREE MASSAGE THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA SMITH (OWNER)
(541) 619-0795
Entity
Organization
Contact information
Practice address
853 S MAIN ST, LEBANON, OR 97355
(541) 619-0795
Mailing address
853 S MAIN ST, LEBANON, OR 97355
(541) 619-0795
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
023223
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
023223
MASSAGE THERAPIST LICENSE
OR
Enumeration date
01/03/2018
Last updated
01/03/2018
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