Provider Demographics
NPI:1558657734
Name:HUNT-SENIFF, LISA RENEE (LMT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:RENEE
Last Name:HUNT-SENIFF
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:RENEE
Other - Last Name:HUNT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:1415 N JESSUP ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-4627
Mailing Address - Country:US
Mailing Address - Phone:574-302-6336
Mailing Address - Fax:
Practice Address - Street 1:1415 N JESSUP ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97217-4627
Practice Address - Country:US
Practice Address - Phone:574-302-6336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-25
Last Update Date:2011-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR17159225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist