Provider Demographics
NPI:1073997466
Name:DELFIORENTINO, NATASHA CHELLE (LMT)
Entity Type:Individual
Prefix:MS
First Name:NATASHA
Middle Name:CHELLE
Last Name:DELFIORENTINO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MRS
Other - First Name:NATASHA
Other - Middle Name:CHELLE
Other - Last Name:APATHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:P.O. BOX 1841
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97709
Mailing Address - Country:US
Mailing Address - Phone:541-903-1288
Mailing Address - Fax:
Practice Address - Street 1:1470 NE 1ST ST.
Practice Address - Street 2:STE #200
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701
Practice Address - Country:US
Practice Address - Phone:541-903-1288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-15
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR20032225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist