NPI 1174817647 · live from the CMS NPI Registry
Andrea M Andrus, LMT
Massage Therapist in Bend, OR. National Provider Identifier 1174817647, active.
NPI record
| NPI | 1174817647 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Massage Therapist 225700000X |
| Practice location | 737 Ne Revere Ave, Bend, OR 97701 |
| Practice phone | 541-241-0384 |
| Mailing address | 19158 Pumice Butte Rd, Bend, OR 97702 |
| Enumerated | June 2, 2011 |
| Last updated | December 18, 2015 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist primary | 225700000X | 10777 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.