Provider Demographics
NPI:1902084999
Name:MURDOCH, LORRAINE WARD (LMT)
Entity Type:Individual
Prefix:MS
First Name:LORRAINE
Middle Name:WARD
Last Name:MURDOCH
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:RAINIE
Other - Middle Name:WARD
Other - Last Name:MURDOCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:842 NW WALL ST STE 6
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-2700
Mailing Address - Country:US
Mailing Address - Phone:541-815-6815
Mailing Address - Fax:
Practice Address - Street 1:1617 SW OVERTURF CT
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-1001
Practice Address - Country:US
Practice Address - Phone:541-388-5021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR8129225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist