MRS. Tina Marie Leavenworth, LMT

NPI #1538451430 in Woodburn, Oregon

Provider Information

NPI Number: 1538451430
Entity Type: Individual
Name: MRS. Tina Marie Leavenworth, LMT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Massage Therapist
Credential: LMT
Enumeration Date: May 10, 2011
Last Updated: Dec 10, 2020

Practice Location

Address: 1755 MOUNT HOOD AVE
City: Woodburn
State: Oregon
ZIP Code: 97071-9096
Phone: (503) 501-0622

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X
Massage Therapist	225700000X	Primary

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