Provider Demographics
NPI:1194974501
Name:LOOMIS, ANN
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:LOOMIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 CASCADE AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-2056
Mailing Address - Country:US
Mailing Address - Phone:541-400-9920
Mailing Address - Fax:
Practice Address - Street 1:202 CASCADE AVE
Practice Address - Street 2:SUITE F
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-2056
Practice Address - Country:US
Practice Address - Phone:541-400-9920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR12637225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist