Provider Demographics
NPI:1003128729
Name:BRAUNSTEIN, BARBARA (LMT, NCTMB)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:
Last Name:BRAUNSTEIN
Suffix:
Gender:F
Credentials:LMT, NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 845
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:OR
Mailing Address - Zip Code:97538-0845
Mailing Address - Country:US
Mailing Address - Phone:541-472-8982
Mailing Address - Fax:541-597-2312
Practice Address - Street 1:18173 REDWOOD HWY
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:OR
Practice Address - Zip Code:97538
Practice Address - Country:US
Practice Address - Phone:541-472-8982
Practice Address - Fax:541-597-2312
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-10
Last Update Date:2010-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5845225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist