Individual
MRS. KARIN I SECREST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT #7488
Contact information
Practice address
656 CHARNELTON ST, EUGENE, OR 97401-2689
(541) 653-8692
Mailing address
1762 W 25TH AVE, EUGENE, OR 97405-1663
(541) 870-8762
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7488
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9727373
DRIVERS LICENSE
OR
Enumeration date
10/11/2019
Last updated
10/11/2019
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