Provider Demographics
NPI:1891842415
Name:SCHAFFER, TAMMY ANN (LMT)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:ANN
Last Name:SCHAFFER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 SE HIGHWAY 101
Mailing Address - Street 2:PMB #377
Mailing Address - City:LINCOLN CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97367-2630
Mailing Address - Country:US
Mailing Address - Phone:541-921-8748
Mailing Address - Fax:
Practice Address - Street 1:4783 SW HIGHWAY 101
Practice Address - Street 2:
Practice Address - City:LINCOLN CITY
Practice Address - State:OR
Practice Address - Zip Code:97367-1564
Practice Address - Country:US
Practice Address - Phone:541-921-8748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR8025225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist