Provider Demographics
NPI:1740432285
Name:FIELDS, SHENA LEE (LMT)
Entity Type:Individual
Prefix:MS
First Name:SHENA
Middle Name:LEE
Last Name:FIELDS
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 1:160 S OAK ST STE 100
Mailing Address - Street 2:PMB 219
Mailing Address - City:SISTERS
Mailing Address - State:OR
Mailing Address - Zip Code:97759
Mailing Address - Country:US
Mailing Address - Phone:541-977-3874
Mailing Address - Fax:
Practice Address - Street 1:270 S SPRUCE ST
Practice Address - Street 2:
Practice Address - City:SISTERS
Practice Address - State:OR
Practice Address - Zip Code:97759-1127
Practice Address - Country:US
Practice Address - Phone:541-977-3874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-15
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR7439225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist