Provider Demographics
NPI:1518317098
Name:ROBBINS, BARRIE (LMT, CTP (TRAGER))
Entity Type:Individual
Prefix:
First Name:BARRIE
Middle Name:
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:LMT, CTP (TRAGER)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2360 NW SUMMERHILL DR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-5293
Mailing Address - Country:US
Mailing Address - Phone:541-241-2087
Mailing Address - Fax:
Practice Address - Street 1:2360 NW SUMMERHILL DR
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-5293
Practice Address - Country:US
Practice Address - Phone:541-241-2087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-15
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR17639225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist