Provider Demographics
NPI:1023338407
Name:SANZ, KAREN LESLIE (M S, LMT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:LESLIE
Last Name:SANZ
Suffix:
Gender:F
Credentials:M S, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 TIARA ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-2357
Mailing Address - Country:US
Mailing Address - Phone:541-520-0175
Mailing Address - Fax:541-683-5082
Practice Address - Street 1:2401 RIVER RD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97404-5414
Practice Address - Country:US
Practice Address - Phone:541-520-0175
Practice Address - Fax:541-683-5082
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-08
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR18922225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist