Provider Demographics
NPI:1962113951
Name:CURREY, MISTY (LMT)
Entity type:Individual
Prefix:
First Name:MISTY
Middle Name:
Last Name:CURREY
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 1:7366 LAKESIDE DR NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97305-9637
Mailing Address - Country:US
Mailing Address - Phone:503-910-2805
Mailing Address - Fax:
Practice Address - Street 1:2367 STATE ST STE 100
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-4505
Practice Address - Country:US
Practice Address - Phone:503-910-2805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-09
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR14243225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist