MCKENZIE VILLANUEVA (NPI# 1124645163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124645163 |
| Entity Type | Individual |
| Full Name | MCKENZIE VILLANUEVA |
| Practice Address |
18 Myrtle St Medford OR 97504-7338 |
| Practice Telephone | 5413010522 |
| Mailing Telephone | 5413010522 |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2020-06-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171W00000X | Contractor | BAP-TA-10200933 | Other Service Providers |
| Street Address |
18 MYRTLE ST |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-7338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679554463 | Athena Wind Goldberg | Social Worker | 18 Myrtle St, Suite 102, Medford, OR 97504-7471 | 2005-11-08 |
| 1265065643 | Brittany Ryan | Massage Therapist | 18 Myrtle St, Medford, OR 97504-7471 | 2020-02-13 |
| 1447708276 | Joleen Melendez | Registered Nurse | 18 Myrtle St, Medford, OR 97504-7471 | 2016-09-21 |
| 1912456765 | Ashley Lyons | Registered Nurse | 18 Myrtle St, Medford, OR 97504-7471 | 2016-09-21 |
| 1679937312 | Kalista Wellness Center LLC | Naturopath | 18 Myrtle St, Medford, OR 97504-7471 | 2016-04-08 |
| 1497181994 | Coriann Ranea Matthews | Counselor | 18 Myrtle St, Medford, OR 97504 | 2013-09-17 |
| 1659356467 | Jeffrey D Thompson | Specialist | 18 Myrtle St, Suite 102, Medford, OR 97504-7471 | 2005-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 171W00000X |
| Grouping | Other Service Providers |
| Classification | Contractor |
| A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |
| Notes: Source: Websters New World Dictionary of the American Language, Second College Edition, William Collins + World Publishing Co., Inc., New York: 1974, p. 308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992841522 | Nancy Jean Dowdy-adams | Contractor | 50 Seymour Ln, Medford, NY 11763-1061 | 2007-01-30 |
| 1073535365 | William Ellis Matthews | Contractor | 1563 Cambridge Cir, Medford, OR 97504-6603 | 2006-07-24 |
| 1902227416 | Katherine Young | Contractor | 836 E Main St, Suite 1, Medford, OR 97504-7115 | 2013-12-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770108615 | Chala Chiri | Contractor | 2498 Aldine Ct Ne, Keizer, OR 97303-1905 | 2020-06-16 |
| 1215568399 | Rebecca Callahan | Contractor | 16979 Sw Steele Way, Beaverton, OR 97006-8935 | 2020-01-28 |
| 1225530512 | Francisco Garcia | Contractor | 18195 Webster Rd Apt 4, Gladstone, OR 97027-1455 | 2018-03-02 |
| 1316469307 | Habtemariam Ketema | Contractor | 16215 Se Webster Rd, Milwaukie, OR 97267-5254 | 2017-07-11 |
| 1720529100 | Morgan Leder | Contractor | 12356 Monitor Mckee Rd Ne, Woodburn, OR 97071-9089 | 2017-03-17 |
| 1982142360 | Brooke Marie Pascoe | Contractor | 6442 Ne 38th Ave, Portland, OR 97211-7812 | 2017-02-06 |
| 1578000956 | Aric Naber | Contractor | 4223 Se 74th Ave, Portland, OR 97206-3415 | 2017-01-24 |
| 1033661251 | Juli Bossert | Contractor | 2305 Ashland St Ste C443, Ashland, OR 97520-3777 | 2016-11-04 |
| 1912459488 | Jin Hwa Chung | Contractor | 1649 Sw 173rd Ter, Beaverton, OR 97003-4262 | 2016-10-31 |
| 1376099093 | Anna Christine Leclerc | Contractor | 2024 Se Clinton Street, Zenana Spa and Wellness Center, Portland, OR 97202 | 2016-09-01 |
| Find all providers with the same taxonomy | ||||
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| 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.