Provider Demographics
NPI:1295323749
Name:BAILEY, HANNAH SUE (LMT)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:SUE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:SUE
Other - Last Name:HARTSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:351 SW CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-1115
Mailing Address - Country:US
Mailing Address - Phone:541-326-6046
Mailing Address - Fax:
Practice Address - Street 1:351 SW CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-1115
Practice Address - Country:US
Practice Address - Phone:541-326-6046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR25614225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty