Provider Demographics
NPI:1609161835
Name:HESBY, ERIN E (LMT)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:E
Last Name:HESBY
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 1:712 NW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-6415
Mailing Address - Country:US
Mailing Address - Phone:503-267-7099
Mailing Address - Fax:541-929-2982
Practice Address - Street 1:712 NW 4TH ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-6415
Practice Address - Country:US
Practice Address - Phone:503-267-7099
Practice Address - Fax:541-929-2982
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-15
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR7402172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist