Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 15234 | OR |
NPI | 1013293893 |
---|---|
Provider Name | Robin Elizabeth Cyphers |
First Address | Lake Oswego, OR 97034-6605 |
Second Address | Lake Oswego, OR 97034-6605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2011 |
Last Update Date | 06/01/2014 |