Provider Demographics
NPI:1477307189
Name:MORSE, GRACE ALLISON (LMT)
Entity type:Individual
Prefix:MS
First Name:GRACE
Middle Name:ALLISON
Last Name:MORSE
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 1:1150 DARLENE LN APT 304
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-1103
Mailing Address - Country:US
Mailing Address - Phone:253-347-3880
Mailing Address - Fax:
Practice Address - Street 1:1473 WILLAMETTE ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4003
Practice Address - Country:US
Practice Address - Phone:541-334-6533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-17
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60611151225700000X
OR26861225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist