NPI 1003239104 · live from the CMS NPI Registry
Jackson Lee Andrews, LMT
Massage Therapist in Powell Butte, OR. National Provider Identifier 1003239104, active.
NPI record
| NPI | 1003239104 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Massage Therapist 225700000X |
| Practice location | 7380 Sw Reif Rd, Powell Butte, OR 97753 |
| Practice phone | 541-213-0491 |
| Enumerated | January 24, 2014 |
| Last updated | January 24, 2014 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist primary | 225700000X | 20031 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.