KEITH ALLEN BRESWICK (NPI# 1265916001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265916001 |
| Entity Type | Individual |
| Full Name | KEITH ALLEN BRESWICK |
| Credential | MS, QMHP |
| Practice Address |
3501 Excel Dr Ste 225 Medford OR 97504-8067 |
| Mailing Address |
1215 Sw G St Grants Pass OR 97526-2544 |
| Practice Telephone | 5414762373 |
| Mailing Telephone | 5414762373 |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2018-09-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
3501 EXCEL DR STE 225 |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-8067 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699163931 | Violeta Iguchi | Counselor | 3501 Excel Dr Ste 225, Medford, OR 97504-8067 | 2015-01-08 |
| 1336660331 | Options for Southern Oregon | Clinic/Center | 3501 Excel Dr Ste 225, Medford, OR 97504-8067 | 2017-06-29 |
| 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 | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952911091 | Araceli Olivares Mciff | Counselor | 201 W 6th St Ste 101, Medford, OR 97501-2708 | 2020-08-04 |
| 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 |
| 1326674417 | Jean Yih Kingston | Counselor | Dcs Mental Health Medford, 151 Mystic Avenue, Medford, MA 02155-4632 | 2020-03-20 |
| 1063059228 | Chiron Center Incorporated | Counselor | 2909 N Phoenix Rd, Medford, OR 97504-9490 | 2019-12-06 |
| 1790321784 | Cassandra F Lawrence | Counselor | 1503 Race Ave, Medford, NY 11763-1859 | 2019-11-25 |
| 1427691955 | Claire Elizabeth Ann Vos | Counselor | 807 Impala Dr, Medford, WI 54451-1206 | 2019-10-28 |
| 1033768718 | Hope Koram | Counselor | 15 Carberry St, Medford, MA 02155-1804 | 2019-09-05 |
| 1649767203 | Kerry Ellis | Counselor | 190 High St Apt 210, Medford, MA 02155-3810 | 2018-04-19 |
| 1942701271 | Winding Tree Counseling Services LLC | Counselor | 916 W 10th St Ste 100, Medford, OR 97501-3018 | 2018-02-22 |
| 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.