Provider Demographics
NPI:1578757779
Name:PRINGLE, MARGI D (LMT)
Entity Type:Individual
Prefix:MISS
First Name:MARGI
Middle Name:D
Last Name:PRINGLE
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 1:3807 WILLAMETTE AVE SE
Mailing Address - Street 2:APT. D
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97322-6553
Mailing Address - Country:US
Mailing Address - Phone:503-409-5434
Mailing Address - Fax:
Practice Address - Street 1:6395 KEIZER STATION BLVD NE
Practice Address - Street 2:SUITE #103
Practice Address - City:KEIZER
Practice Address - State:OR
Practice Address - Zip Code:97303-2305
Practice Address - Country:US
Practice Address - Phone:503-589-1597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR13022225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist