Provider Demographics
NPI:1346534450
Name:GALVER, STEPHANIE MARIE (LMT)
Entity Type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:MARIE
Last Name:GALVER
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 1:233 MADRONA AVE SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-4609
Mailing Address - Country:US
Mailing Address - Phone:503-999-5423
Mailing Address - Fax:
Practice Address - Street 1:233 MADRONA AVE SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4609
Practice Address - Country:US
Practice Address - Phone:503-999-5423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-06
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR18087172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist