HALLIE IVERSEN (NPI# 1770932097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770932097 |
| Entity Type | Individual |
| Full Name | HALLIE IVERSEN |
| Practice Address |
100 E Main St Ste C Medford OR 97501-6041 |
| Mailing Address |
3587 Heathrow Way Medford OR 97504-4004 |
| Practice Telephone | 5412002900 |
| Practice Fax Number | 5412002948 |
| Mailing Telephone | 5418588170 |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2017-03-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
201408131 | OR | Nursing Service Providers |
| Street Address |
100 E MAIN ST STE C |
| City | MEDFORD |
| State | OR |
| Zip Code | 97501-6041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497778500 | Timothy Reed | Psychiatry & Neurology | 100 E Main St Ste C, Medford, OR 97501-6041 | 2006-07-26 |
| 1447779293 | Rosy E Almazan | Counselor | 100 E Main St Ste C, Medford, OR 97501-6041 | 2017-09-13 |
| 1306361100 | Holly Macgowan | Counselor | 100 E Main St Ste C, Medford, OR 97501-6041 | 2017-08-14 |
| 1295250660 | Daniel Chung | Counselor | 100 E Main St Ste C, Medford, OR 97501-6041 | 2017-08-07 |
| 1952838393 | Erin George | Counselor | 100 E Main St Ste C, Medford, OR 97501-6041 | 2017-05-16 |
| 1437682523 | Samantha Gregory-queen | Counselor | 100 E Main St Ste C, Medford, OR 97501-6041 | 2017-04-06 |
| 1346773439 | Brittney Havey | Counselor | 100 E Main St Ste C, Medford, OR 97501-6041 | 2017-04-06 |
| 1518403369 | Andrea Sukraw | Counselor | 100 E Main St Ste C, Medford, OR 97501-6041 | 2017-01-17 |
| 1093250326 | Emily Parker | Counselor | 100 E Main St Ste C, Medford, OR 97501-6041 | 2016-12-22 |
| 1659737625 | Jennifer Knutson | Counselor | 100 E Main St Ste C, Medford, OR 97501-6041 | 2016-01-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366069494 | Brian Snapp | Counselor | 1191 Hazel St, Medford, OR 97501 | 2020-07-06 |
| 1477174761 | Corey Renfree | Counselor | 1191 Hazel Street, Medford, OR 97501 | 2020-04-28 |
| 1669012928 | One of A Kind Therapy LLC | Social Worker | 916 West 10th St #205, Medford, OR 97501 | 2020-01-14 |
| 1265993620 | Star Dialysis LLC | Clinic/Center | 50 Rossanley Dr, Medford, OR 97501 | 2019-03-28 |
| 1962972463 | Karen Elise Roertgen | Counselor | 328 So. Central Ave., Suite 204, Medford, OR 97501 | 2018-11-28 |
| 1316458813 | Rick's Medical Supply, Inc | Durable Medical Equipment & Medical Supplies | 562 Parsons Drive, Suite 114, Medford, OR 97501 | 2017-10-24 |
| 1750807111 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 821 N Riverside Ave, Medford, OR 97501 | 2017-08-17 |
| 1992229009 | Cassandra Schultz | Massage Therapist | 824 East Jackson, Suite A, Medford, OR 97501 | 2017-07-31 |
| 1972962355 | Robin Clevenger | Peer Specialist | 301 S Ivy St, Medford, OR 97501 | 2016-02-15 |
| 1154706984 | Debbie Diane Orr | Behavioral Analyst | 1024 West 9th Street, Medford, OR 97501 | 2015-07-22 |
| Find all providers in zip 97501 | ||||
| Taxonomy Code | 163WP0808X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710453121 | Tarah Wright | Registered Nurse | 239 Taunton Blvd Ste A2, Medford, NJ 08055-3471 | 2018-10-23 |
| 1285853341 | Kirk William Austbo | Registered Nurse | 1911 Hazel St., Medford, OR 97504 | 2007-04-25 |
| 1902424948 | Christopher Joseph D'amore | Registered Nurse | 3200 Juanipero Way, Medford, OR 97504-8580 | 2020-07-07 |
| 1174002091 | Tiffany A Weldon | Registered Nurse | 3587 Heathrow Way, Medford, OR 97504-4004 | 2018-08-10 |
| 1790235166 | Dieguita Ann Montgomery | Registered Nurse | 140 S Holly St, Medford, OR 97501-3113 | 2016-10-10 |
| 1619393253 | Dianne Christine Helmer | Registered Nurse | 140 South Holly Street, Medford, OR 97501 | 2014-03-06 |
| 1891122099 | Michael W Downey | Registered Nurse | 31 Industrial Blvd, Medford, NY 11763-2220 | 2013-10-02 |
| 1518282573 | Deborah Sue Roenbeck | Registered Nurse | 31 Industrial Blvd, Medford, NY 11763-2220 | 2010-04-02 |
| 1962681460 | Lisa Mccordic | Registered Nurse | 151 Mystic Ave, Suite Six, Medford, MA 02155-4632 | 2007-10-31 |
| 1740497437 | Beth Ann Jackson | Registered Nurse | 1005 E Main St, Medford, OR 97504-7448 | 2007-05-16 |
| 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.