Provider Demographics
NPI:1437683505
Name:ALVAREZ-SIMMONS, PATRICIA ANN (LMT)
Entity Type:Individual
Prefix:
First Name:PATRICIA ANN
Middle Name:
Last Name:ALVAREZ-SIMMONS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:PATTY
Other - Middle Name:
Other - Last Name:ALVAREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:59911 HOPI RD
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-7934
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:701 NW ARIZONA AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-3298
Practice Address - Country:US
Practice Address - Phone:541-728-3911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-16
Last Update Date:2017-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR11890225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist