Provider Demographics
NPI:1821392069
Name:TWENGE, DEANNA MARIE (LMT)
Entity Type:Individual
Prefix:MS
First Name:DEANNA
Middle Name:MARIE
Last Name:TWENGE
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 1:21600 SW FINNIGAN HILL RD
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-8718
Mailing Address - Country:US
Mailing Address - Phone:503-538-9287
Mailing Address - Fax:
Practice Address - Street 1:21600 SW FINNIGAN HILL RD
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-8718
Practice Address - Country:US
Practice Address - Phone:503-538-9287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-03
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2610247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other