Elder, Susannah Jane

Elder, Susannah Jane is an sole proprietor health care provider with primary practice located at 832 E Main St Ste. 6, Medford OR 97504-7153. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Elder, Susannah Jane can be contacted via phone (541) 772-5939.

Contact Information

Primary practice address
832 E Main St Ste. 6 Medford OR 97504-7153
Fax: (541) 770-5939
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 10482 Oregon

Profile Details

NPI number 1518039890
LBN Legal business name Elder, Susannah Jane
Credentials L.M.T., NCBTMB
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 14th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518039890 NPPES
Oregon Other 10482 BOARD OF MASSAGE LICENSE

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