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Ms. Susannah Jane Elder, LMT,NCBTMB
Specialist in Medford, Oregon
NPI 1518039890

Susannah Jane Elder is a Specialist based in Medford, OR. Susannah Jane Elder practices in Medford, OR and has the professional credentials of LMT,NCBTMB. The NPI Number for Susannah Jane Elder is 1518039890 and holds a License No. 10482 (Oregon).

The current practice location address for Susannah Jane Elder is 832 E Main St, Medford, OR and can be reached out via phone at 541-772-5939 and via fax at 541-770-5939.

Location: 832 E Main St, Medford, OR, 97504-7153
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1518039890
Provider Name
Susannah Jane Elder
Credential
LMT,NCBTMB
Provider Entity Type
Individual
Gender
Female
Address
832 E Main St, Medford, OR, 97504-7153
Phone Number
541-772-5939
Fax Number
541-770-5939
Provider Enumeration Date
11/14/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
10482 01 OR BOARD OF MASSAGE LICENSE
institution
Provider Business Practice Location Address Details
Address
832 E Main St
City
Medford
State
Oregon
Zip
97504-7153
Phone Number
541-772-5939
Fax Number
541-770-5939
person
Provider Business Mailing Address Details
Address
832 E Main St
City
Medford
State
Oregon
Zip
97504-7153
Phone Number
541-772-5939
Fax Number
541-770-5939
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
10482 (Oregon)
Definition
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.
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