Provider Demographics
NPI:1699597088
Name:REPLENISH MASSAGE & SKIN CARE STUDIO LLC
Entity type:Organization
Organization Name:REPLENISH MASSAGE & SKIN CARE STUDIO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TREBES
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, LE
Authorized Official - Phone:541-270-2245
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty