Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter | ||
Y | 225700000X | Massage Therapist | 3724 | OR |
NPI | 1114337730 |
---|---|
Provider Name | Martha Blanchet |
First Address | Eugene, OR 97405-2373 |
Second Address | Eugene, OR 97405-2373 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2014 |
Last Update Date | 06/05/2014 |