Provider Demographics
NPI:1235451923
Name:ZANOTTI, ABIGAIL ROSE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:ROSE
Last Name:ZANOTTI
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 1:2459 SE MICAH PL
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-1965
Mailing Address - Country:US
Mailing Address - Phone:541-758-8430
Mailing Address - Fax:
Practice Address - Street 1:380 HICKORY ST NW
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-1726
Practice Address - Country:US
Practice Address - Phone:541-926-2264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2670225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist