MS. SUSANNAH JANE ELDER (NPI# 1518039890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518039890 |
| Entity Type | Individual |
| Full Name | MS. SUSANNAH JANE ELDER |
| Credential | L.M.T., NCBTMB |
| Practice Address |
832 E Main St Ste. 6 Medford OR 97504-7153 |
| Practice Telephone | 5417725939 |
| Practice Fax Number | 5417705939 |
| Mailing Telephone | 5417725939 |
| Mailing Fax Number | 5417705939 |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 10482 | OR | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | BOARD OF MASSAGE LICENSE | 10482 | 01 |
| Street Address |
832 E MAIN ST STE. 6 |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-7153 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497752414 | Orvis Enterprises, Inc | Radiologic Technologist | 832 E Main St, Suite 4, Medford, OR 97504-7153 | 2005-07-05 |
| 1528684255 | Woollard Ipsen Managment LLC | Behavioral Analyst | 832 E Main St, Medford, OR 97504-7153 | 2020-06-18 |
| 1679928543 | Summer Waters, LLC | Nutritionist | 832 E Main St, Suite 3, Medford, OR 97504-7153 | 2016-04-28 |
| 1174852602 | Christine Allison Rackley | Massage Therapist | 832 E Main St, Medford, OR 97504-7153 | 2009-12-11 |
| 1770723363 | Gordon Wayne Grafton Jr. | Massage Therapist | 832 E Main St, 5, Medford, OR 97504-7153 | 2009-02-23 |
| 1699910257 | Ralph Kenneth Duffin Sr. | Dentist | 832 E Main St, Ste. 10, Medford, OR 97504-7153 | 2008-12-11 |
| 1619099611 | Matthew Sheehan | Chiropractor | 832 E Main St, Suite 5, Medford, OR 97504-7153 | 2007-04-03 |
| 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 | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629687702 | Joy Dunn | Specialist | 1801 Fire Ave, Medford, NY 11763-1783 | 2020-07-24 |
| 1316572027 | Rebecca Molino | Specialist | 9, 3251 Ny-112 #2, Medford, NY 11763 | 2020-03-03 |
| 1619450525 | Erica Sanniola | Specialist | 55 Apple Ln, Medford, NY 11763-4044 | 2018-09-07 |
| 1922592906 | Elizabeth L Oakley | Specialist | 1 Sprat St, Medford, NY 11763 | 2018-06-21 |
| 1093267114 | Rhiannon Skye Sgambati | Specialist | 152 Fordham Ave, Medford, NY 11763-3107 | 2016-10-25 |
| 1518326685 | Betty Velez | Specialist | 21 Red Pine Rd, Medford, NY 11763 | 2016-02-18 |
| 1932565660 | Vincent Giardina Jr. | Specialist | 1 Elena Ct, Medford, NJ 08055-9175 | 2016-01-11 |
| 1730551417 | Carson Mckee Case | Specialist | 924 E. Jackson, Medford, OR 97504 | 2015-10-21 |
| 1841674066 | Zachary Fisher | Specialist | 200 Peekskill Ave, Medford, NY 11763-3123 | 2015-07-17 |
| 1720472798 | Stephanie Mullen | Specialist | 173 Buffalo Ave, Medford, NY 11763-3714 | 2015-03-26 |
| 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.