Provider Demographics
NPI:1932363181
Name:FREYRE, MARIE HELEN (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:HELEN
Last Name:FREYRE
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1863 PIONEER PKWY E # 621
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-3907
Mailing Address - Country:US
Mailing Address - Phone:541-954-7311
Mailing Address - Fax:
Practice Address - Street 1:1863 PIONEER PKWY E #621
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-3907
Practice Address - Country:US
Practice Address - Phone:541-954-7311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5827111NR0400X
247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
No111NR0400XChiropractic ProvidersChiropractorRehabilitation