SAM MACKENZIE LANE (NPI# 1114413010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114413010 |
| Entity Type | Individual |
| Full Name | SAM MACKENZIE LANE |
| Credential | LMT |
| Practice Address |
1661 Edgewater St Nw # 120, Salem, Or 97304 Salem OR 97304 |
| Mailing Address |
1695 Ashland Ct Nw Salem OR 97304-2075 |
| Practice Telephone | 5035803961 |
| Mailing Telephone | 5039319178 |
| Enumeration Date | 2018-07-03 |
| Last Update Date | 2018-07-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 23778 | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | SAM LANE | 23778 | 01 |
| Street Address |
1661 EDGEWATER ST NW # 120, SALEM, OR 97304 |
| City | SALEM |
| State | OR |
| Zip Code | 97304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144761131 | Rachel E Carson | Physical Therapist | 1025 2nd St. Nw, West Salem, OR 97304 | 2017-03-10 |
| 1962951061 | Lee Ann Nail | Social Worker | 3965 Gibson Rd Nw, Salem, OR 97304 | 2016-09-29 |
| 1619421591 | Logan Walters | Physical Therapist | 1025 2nd St Nw, Salem, OR 97304 | 2016-08-09 |
| 1770941338 | Tysandra Gillis | Massage Therapist | 859 Mule Deer St., Salem, OR 97304 | 2016-02-10 |
| 1144620295 | Molly Rodden | Nurse Practitioner | 1174 Cornucopia St Nw Ste 240, Salem, OR 97304 | 2014-08-26 |
| 1881942126 | Cynthia Ruth Rettler | Registered Nurse | 1520 Plaza St Nw Ste 150, Salem, OR 97304 | 2012-08-16 |
| 1336401017 | Trillium Family Services | Community/Behavioral Health | 1520 Plaza Street Nw, Suite 100, Salem, OR 97304 | 2012-06-08 |
| 1033428198 | Kathleen Ketelson | Nurse Practitioner | 560 Wallace Rd Nw Ste 140, Salem, OR 97304 | 2010-10-06 |
| 1922332535 | Robert Scott Mcadam | Social Worker | 1245 Edgewater St. Nw, Salem, OR 97304 | 2009-09-29 |
| 1992932560 | Michelle Lynn Laseter | Counselor | 290 Moyer Ln. Nw, Salem, OR 97304 | 2009-06-22 |
| Find all providers in zip 97304 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437766953 | Michael Amador | Massage Therapist | 95 Stiles Rd Ste 107, Salem, NH 03079-4805 | 2020-09-29 |
| 1528673464 | Brandy Mckeever | Massage Therapist | 156 Front St Ne, Salem, OR 97301-3479 | 2020-09-08 |
| 1114531274 | Michelle Nicole Kellogg-satrum | Massage Therapist | 1900 Hines St Se Ste 110, Salem, OR 97302-1356 | 2020-09-04 |
| 1518579481 | Stephanie Shambaugh | Massage Therapist | 456 State St Ste 110, Salem, OR 97301-3619 | 2020-08-20 |
| 1770115230 | Angela Aloisi | Massage Therapist | 1236 W Main St, Salem, VA 24153-4726 | 2020-02-12 |
| 1245874445 | Jessica Schutt | Massage Therapist | 156 Front St Ne Ste 100, Salem, OR 97301-3479 | 2019-10-30 |
| 1174185391 | Jennifer Plemons | Massage Therapist | 2685 Gilbert St S, Salem, OR 97302-5853 | 2019-07-08 |
| 1811559305 | Jordan D Hilbert | Massage Therapist | 2110 Berry St Se, Salem, OR 97302-2108 | 2019-07-03 |
| 1942865167 | Pure Massage & Spa LLC | Massage Therapist | 4155 Rickey St Se Ste 122, Salem, OR 97317-6903 | 2019-05-02 |
| 1942767553 | Crystal Vanpelt | Massage Therapist | 2111 Front St Ne Bldg 3, Salem, OR 97301-0765 | 2019-03-01 |
| Find all providers in SALEM | ||||
Please comment or provide details below to improve the information on SAM MACKENZIE LANE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.