Provider Demographics
NPI:1164231817
Name:DUMBECK, LILLIAN SALLY (LMT)
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:SALLY
Last Name:DUMBECK
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 1:21356 PELICAN DR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-9690
Mailing Address - Country:US
Mailing Address - Phone:541-281-8850
Mailing Address - Fax:
Practice Address - Street 1:21356 PELICAN DR
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-9690
Practice Address - Country:US
Practice Address - Phone:541-281-8850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR28263225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist