ADRIANNA JUMPING EAGLE (NPI# 1417310236) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417310236 |
| Entity Type | Individual |
| Full Name | ADRIANNA JUMPING EAGLE |
| Credential | CADC II |
| Practice Address |
1003 E Main St Suite 104 Medford OR 97504-7448 |
| Practice Telephone | 5417791282 |
| Practice Fax Number | 5417792081 |
| Mailing Telephone | 5417791282 |
| Mailing Fax Number | 5417792081 |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2016-03-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
14-R-45 | OR | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 134150 | 05 |
| Street Address |
1003 E MAIN ST SUITE 104 |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-7448 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134772627 | Jessica Michelle Lien | Counselor | 1003 E Main St, Medford, OR 97504-7140 | 2019-07-23 |
| 1245793082 | Mari Sargent | Counselor | 1003 E Main St, Medford, OR 97504-7140 | 2019-04-09 |
| 1245685569 | Jesalyn Moore | Counselor | 1003 E Main St, Medford, OR 97504-7448 | 2016-04-25 |
| 1891149720 | Paul A Rock | Counselor | 1003 E Main St, Medford, OR 97504-7448 | 2016-04-18 |
| 1578917795 | Lisa Milhoan-vancurler | Counselor | 1003 E Main St, Medford, OR 97504-7448 | 2016-04-14 |
| 1821451840 | Annette Teeples | Counselor | 1003 E Main St, Medford, OR 97504-7448 | 2016-03-29 |
| 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 | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124685870 | Tracy L Sunde | Counselor | 512 4th St Sw, Medford, MN 55049-9568 | 2019-05-28 |
| 1245737956 | Larkspur Counseling LLC | Counselor | 328 S Central Ave Ste 212, Medford, OR 97501-7274 | 2018-04-09 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1255875654 | Danielle E Peterson | Counselor | 429 W Broadway Ave, Medford, WI 54451-1608 | 2016-12-05 |
| 1376099523 | Patricia Mcatee | Counselor | 243 N Holly St, Apt 1, Medford, OR 97501-5603 | 2016-08-28 |
| 1437512449 | Sage Bosch | Counselor | 1003 E Main St # 104, Medford, OR 97504-7448 | 2016-03-29 |
| 1114385853 | April Collins-macauley | Counselor | 234 W 5th St, Medford, OR 97501-2611 | 2016-02-09 |
| 1154714418 | Marykay Powell | Counselor | 4175 Cedar Ln, Medford, OR 97501-9611 | 2015-03-11 |
| 1699163931 | Violeta Iguchi | Counselor | 3501 Excel Dr Ste 225, Medford, OR 97504-8067 | 2015-01-08 |
| 1790109049 | Ellen Lynch | Counselor | 3251 Route 112 Ste 2, Medford, NY 11763-1446 | 2014-02-06 |
| Find all providers in MEDFORD | ||||
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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.