Provider Demographics
NPI:1548557572
Name:MCCARLEY, HEATHER ANNE (LMT)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:ANNE
Last Name:MCCARLEY
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 1:1142 WILLAGILLESPIE RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2142
Mailing Address - Country:US
Mailing Address - Phone:541-870-1239
Mailing Address - Fax:541-343-4913
Practice Address - Street 1:1142 WILLAGILLESPIE RD
Practice Address - Street 2:SUITE 10
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2142
Practice Address - Country:US
Practice Address - Phone:541-343-4913
Practice Address - Fax:541-343-4913
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR7967225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist