Provider Demographics
NPI:1114050341
Name:TAUSCHER, GUY (BA, LMT)
Entity Type:Individual
Prefix:MR
First Name:GUY
Middle Name:
Last Name:TAUSCHER
Suffix:
Gender:M
Credentials:BA, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-1720
Mailing Address - Country:US
Mailing Address - Phone:541-490-2986
Mailing Address - Fax:
Practice Address - Street 1:706 COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1720
Practice Address - Country:US
Practice Address - Phone:541-490-2986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10664225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA73848OtherLABOR AND INDUSTRY INSURA
OR10664OtherOR STATE MASSAGE LICENSE
19795OtherAMTA MEMBER
WAMA00005292OtherWA MASSAGE LICENSE NUMBER