Provider Demographics
NPI:1457505737
Name:MESSIER, KIM MARIE (LAC)
Entity Type:Individual
Prefix:MRS
First Name:KIM
Middle Name:MARIE
Last Name:MESSIER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MS
Other - First Name:KIM
Other - Middle Name:MARIE
Other - Last Name:LABENSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:17445 SNOW GOOSE RD
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97707-2333
Mailing Address - Country:US
Mailing Address - Phone:541-948-9455
Mailing Address - Fax:541-550-7530
Practice Address - Street 1:17445 SNOW GOOSE RD
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97707-2333
Practice Address - Country:US
Practice Address - Phone:541-948-9455
Practice Address - Fax:541-550-7530
Is Sole Proprietor?:No
Enumeration Date:2008-11-12
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC01209171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist