Provider Demographics
NPI:1881810026
Name:HASTINGS, JOANNE MARIE (LMT)
Entity type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:MARIE
Last Name:HASTINGS
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 1:727 NW 12TH ST
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-5936
Mailing Address - Country:US
Mailing Address - Phone:541-758-9004
Mailing Address - Fax:
Practice Address - Street 1:OREGON STATE UNIVERSITY
Practice Address - Street 2:201 PLAGEMAN BUILDING
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97331-5801
Practice Address - Country:US
Practice Address - Phone:541-737-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6973225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist