Grace Carole Herring, LMT
Individual provider Active NPI Massage Therapist · Phoenix, OR
NPI 1174348015 · NPPES record last updated Nov 16, 2024
Key facts
- NPI
- 1174348015
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 25601 (OR)
- Practice address
- 1404 Camp Baker Rd
Phoenix, OR 97535-9604 - Phone
- (575) 644-1812
- NPI assigned
- Nov 16, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25601 | OR | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 25601 | OR | Yes |
Addresses
Primary practice location
1404 Camp Baker Rd
Phoenix, OR 97535-9604
Mailing address
1404 Camp Baker Rd
Phoenix, OR 97535-9604
Phone (575) 644-1812
Other providers in Phoenix, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.