Doctor Name: | WANDA MARIE LOVE |
NPI Number: | 1447260690 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT CR |
License Number: | 10838 |
Business Practice Address: | 909 Se Cedar St Hillsboro, OR - 97123 |
Business Phone Number: | 5036190408 |
Business Fax Number: | |
Mailing Address: | 46617 Nw Hillside Rd, FOREST GROVE |
State: | OR |
Postal Code: | 97116 |
Phone Number: | 5033575922 |
Fax Number: | |
NPI Enumeration Date: | 08/09/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 10838 |
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. |