Provider Demographics
NPI:1346545720
Name:LUTZ, ROBBIE DEE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:ROBBIE
Middle Name:DEE
Last Name:LUTZ
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 1:2536 SW 43RD PL
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-1981
Mailing Address - Country:US
Mailing Address - Phone:541-350-9251
Mailing Address - Fax:
Practice Address - Street 1:354 NE GREENWOOD AVE STE 202
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4632
Practice Address - Country:US
Practice Address - Phone:541-350-9251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-17
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X, 174400000X
OR11930225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No174400000XOther Service ProvidersSpecialist