Lacey Fisher, LMT
Individual provider Active NPI Massage Therapist · Banks, OR
NPI 1487065017 · NPPES record last updated Dec 21, 2023
Key facts
- NPI
- 1487065017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 19944 (OR)
- Practice address
- 13590 NW Main St
Banks, OR 97106-9057 - Phone
- (971) 205-2023
- NPI assigned
- May 16, 2014
- 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 |
|---|---|---|---|
| 19944 | OR | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 19944 | OR | Yes |
Addresses
Primary practice location
13590 NW Main St
Banks, OR 97106-9057
Mailing address
13590 NW Main St
Banks, OR 97106-9057
Phone (971) 205-2023
Other providers in Banks, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 21, 2023. 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.