Provider Demographics
NPI:1194374926
Name:COWAN, LEAH (LMT)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:COWAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32044 COBURG BOTTOM LOOP RD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408-9471
Mailing Address - Country:US
Mailing Address - Phone:541-606-7661
Mailing Address - Fax:
Practice Address - Street 1:160 E BROADWAY STE 200
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3140
Practice Address - Country:US
Practice Address - Phone:541-606-7661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-04
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR25144225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty