Lois M Livengood, L.M.T.

Individual provider Active NPI Contractor · Grants Pass, OR

NPI 1831361799 · NPPES record last updated Mar 31, 2008

Key facts

NPI
1831361799
Entity type
Individual (NPI type 1)
Primary specialty
Contractor 171W00000X
License
11591 (OR)
Practice address
544 Union Ave
Grants Pass, OR 97527-5544
Phone
(541) 955-0940
Fax
(541) 955-5233
NPI assigned
Mar 31, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
11591ORMDContractor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 11591 OR Yes

Addresses

Primary practice location

544 Union Ave
Grants Pass, OR 97527-5544

Mailing address

544 Union Ave
Grants Pass, OR 97527-5544
Phone (541) 955-0940

Other providers in Grants Pass, OR

All providers in Grants Pass, OR · Contractor in Oregon

Sources for this page

Verify at the official NPI Registry.