Individual provider · Type 1 NPI

Robert Richard Ellestad, LMT

Massage Therapist · Salem, OR

NPI number 1174762520 Active

Practice location

300 Glen Creek Rd NW
Salem, OR 97304-3058

Call (503) 507-2730 Map

Mailing address

1468 Falcon Loop
Independence, OR 97351-1538

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X14560 (OR)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1174762520

Robert Richard Ellestad, LMT's National Provider Identifier is 1174762520, issued on Feb 9, 2009. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Salem, OR. The record was last updated on Feb 9, 2009.