Doctor Name: | THERESA DONAVANT-BUTLER |
NPI Number: | 1154713295 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT9185 |
License Number: | 9185 |
Business Practice Address: | 564 Glatt Circle Woodburn, OR - 97071 |
Business Phone Number: | 5032500127 |
Business Fax Number: | |
Mailing Address: | Po Box 1112, WOODBURN |
State: | OR |
Postal Code: | 970711112 |
Phone Number: | 5032500127 |
Fax Number: | |
NPI Enumeration Date: | 02/26/2015 |
NPI Last Update Date: | 02/26/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 9185 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |