Provider Demographics
NPI:1285456707
Name:TREBES, KATIE DAWN (LMT, LE)
Entity type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:DAWN
Last Name:TREBES
Suffix:
Gender:F
Credentials:LMT, LE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2252 LEONARD LN
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OR
Mailing Address - Zip Code:97355-1186
Mailing Address - Country:US
Mailing Address - Phone:541-270-2245
Mailing Address - Fax:
Practice Address - Street 1:707 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355-3209
Practice Address - Country:US
Practice Address - Phone:541-270-2245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR26623225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist