Provider Demographics
NPI:1558051326
Name:MASCHMEDT, JENNY MARIE (LMT)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:MARIE
Last Name:MASCHMEDT
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 1:60227 OCHOCO CIR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-8903
Mailing Address - Country:US
Mailing Address - Phone:360-907-9281
Mailing Address - Fax:
Practice Address - Street 1:335 NE 4TH ST
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-5162
Practice Address - Country:US
Practice Address - Phone:541-668-7506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist