Provider Demographics
NPI:1235698895
Name:GRABOYES-REED, CHASE MACKENZIE (LMT)
Entity Type:Individual
Prefix:MR
First Name:CHASE
Middle Name:MACKENZIE
Last Name:GRABOYES-REED
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20622 SE 269TH ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-6130
Mailing Address - Country:US
Mailing Address - Phone:541-844-8872
Mailing Address - Fax:
Practice Address - Street 1:656 CHARNELTON ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2689
Practice Address - Country:US
Practice Address - Phone:541-653-8692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-13
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR24844225700000X
WAMA60922727225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist