Tracey Anthony, LMT
Individual provider Active NPI Massage Therapist · Bend, OR
NPI 1659605095 · NPPES record last updated Oct 1, 2009
Key facts
- NPI
- 1659605095
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 13467 (OR)
- Practice address
- 1470 NW First St
Suite 200
Bend, OR 97701 - Phone
- (541) 410-7320
- NPI assigned
- Oct 1, 2009
- 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 |
|---|---|---|---|
| 13467 | OR | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 13467 | OR | Yes |
Addresses
Primary practice location
1470 NW First St
Suite 200
Bend, OR 97701
Mailing address
69260 Crooked Horseshoe Rd
Sisters, OR 97759-9602
Phone (541) 549-0821
Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 1, 2009. 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.