Doctor Name: | LAURA LYNN GREEN |
NPI Number: | 1528198322 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMP,LMT, EMT |
License Number: | 7105 |
Business Practice Address: | 1000 East Jewett Blvd. White Salmon, WA - 98672 |
Business Phone Number: | 5094933142 |
Business Fax Number: | |
Mailing Address: | 218 Lyle Snowden Rd, LYLE |
State: | WA |
Postal Code: | 986359537 |
Phone Number: | 5093656870 |
Fax Number: | |
NPI Enumeration Date: | 03/07/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 7105 |
Healthcare Provider Taxonomy: (Secondary) | N |
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. |