Doctor Name: | MRS. TABITHA WHITE |
NPI Number: | 1669800488 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.M.T. |
License Number: | 17671 |
Business Practice Address: | 657 Ne Hood Ave Gresham, OR - 970307328 |
Business Phone Number: | 5036617811 |
Business Fax Number: | 5036615723 |
Mailing Address: | 657 Ne Hood Ave, GRESHAM |
State: | OR |
Postal Code: | 970307328 |
Phone Number: | 5036617811 |
Fax Number: | 5036615723 |
NPI Enumeration Date: | 10/15/2013 |
NPI Last Update Date: | 10/15/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 17671 |
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. |