Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 023527 | OR |
NPI | 1003311499 |
---|---|
Provider Name | Valerie Schlaht |
First Address | Grants Pass, OR 97526-3025 |
Second Address | Grants Pass, OR 97526-3025 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2018 |
Last Update Date | 27/03/2018 |