Provider Demographics
NPI:1366937641
Name:CAVAROC, MARIE (RN, LMT)
Entity type:Individual
Prefix:MS
First Name:MARIE
Middle Name:
Last Name:CAVAROC
Suffix:
Gender:F
Credentials:RN, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1471 PEARL ST STE 2
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4603
Mailing Address - Country:US
Mailing Address - Phone:541-342-8106
Mailing Address - Fax:
Practice Address - Street 1:1471 PEARL ST STE 2
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4603
Practice Address - Country:US
Practice Address - Phone:541-342-8106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-28
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3521225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist