Provider Demographics
NPI:1740863372
Name:QUIGLEY, ANNIE CLAIRE (LMT)
Entity type:Individual
Prefix:MS
First Name:ANNIE
Middle Name:CLAIRE
Last Name:QUIGLEY
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 1:951 E 19TH AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97403-1323
Mailing Address - Country:US
Mailing Address - Phone:541-350-4786
Mailing Address - Fax:
Practice Address - Street 1:492 E 13TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4250
Practice Address - Country:US
Practice Address - Phone:541-342-4520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-02
Last Update Date:2021-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR25970225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist