EARTH SONG MEDICAL PRACTICE LLC (NPI# 1912462144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912462144 |
| Entity Type | Organization |
| Organization Name | EARTH SONG MEDICAL PRACTICE LLC |
| Practice Address |
18173 Redwood Hwy Selma OR 97538 |
| Mailing Address |
4567 Deer Creek Rd Selma OR 97538-9612 |
| Practice Telephone | 5412374470 |
| Mailing Telephone | 5412374470 |
| Enumeration Date | 2019-02-01 |
| Last Update Date | 2019-02-01 |
| Authorized Official Name | MICHAEL G PRUNER (OWNER/MANAGER) |
| Authorized Official Telephone | 5412374470 |
| Authorized Official Credential | ANP-BC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
18173 REDWOOD HWY |
| City | SELMA |
| State | OR |
| Zip Code | 97538 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699767103 | Katherine Mechling | Family Medicine | 18173 Redwood Hwy, Selma, OR 97538-9732 | 2005-08-19 |
| 1588046064 | Daniel Hagerty | Nurse Practitioner | 18173 Redwood Hwy, Po Box 847, Selma, OR 97538-1257 | 2015-06-22 |
| 1730441023 | Elbert C Collins Md | Obstetrics & Gynecology | 18173 Redwood Hwy, Selma, OR 97538 | 2012-06-12 |
| 1003128729 | Barbara Braunstein | Massage Therapist | 18173 Redwood Hwy, Selma, OR 97538 | 2010-07-10 |
| 1861681967 | Katherine Mechling | Clinic/Center | 18173 Redwood Hwy, Selma, OR 97538-0847 | 2007-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871810580 | Lacy M Miller | Registered Nurse | 1874 Lakeshore Dr., Selma, OR 97538 | 2010-04-21 |
| 1245531664 | Peggie Meredith Harris | Physical Therapist | 18255 Redwood Hwy, Selma, OR 97538 | 2010-11-17 |
| 1447420674 | Jacqueline T. Farless | Contractor | 5616 Lake Shore Dr, Selma, OR 97538-9711 | 2008-03-04 |
| 1386740736 | Kay Nielson Pta LLC | Clinic/Center | 18255 Redwood Hwy, Selma, OR 97538-9729 | 2006-09-15 |
| 1063653046 | Kay Marie Nielson | Massage Therapist | 18255 Redwood Hwy, Selma, OR 97538-9729 | 2009-03-20 |
| 1295855831 | Kailua Naoni Long | Dental Hygienist | 1360 Mcmullen Creek Rd, Selma, OR 97538-9749 | 2007-03-29 |
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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|---|---|---|---|---|
| 1801097613 | Valley Family Health Center | Clinic/Center | 1239 Rose Ave, Selma, CA 93662-3227 | 2007-05-30 |
| 1760693923 | Central Valley Maternal & Child Care Centers | Clinic/Center | 1239 Rose Ave, Selma, CA 93662-3227 | 2007-05-26 |
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| 1104447895 | Beyond Health LLC | Clinic/Center | 6440 Nw Mcmullen Ave, Portland, OR 97229-1158 | 2020-05-04 |
| 1851942536 | Careatc | Clinic/Center | 1101 W Main St Ste 103, Medford, OR 97501-2966 | 2019-09-24 |
| 1871153585 | Full Bloom Natural Medicine, LLC | Clinic/Center | 922 Nw Circle Blvd Ste 180, Corvallis, OR 97330-1483 | 2019-06-14 |
| 1831757475 | Structural Solutions Chiropractic | Clinic/Center | 121 Nw Everett St, Portland, OR 97209-4049 | 2019-05-29 |
| 1770147357 | Uptown Providers PC | Clinic/Center | 397 Warner Milne Rd, Oregon City, OR 97045-4045 | 2019-04-29 |
| 1720549058 | Barbara Gilbertson, Do, Inc. | Clinic/Center | 1803b Main St, Klamath Falls, OR 97601-2636 | 2019-03-28 |
| 1033674841 | Jeremy Mikolai Nd Inc | Clinic/Center | 2540 Ne M L King Blvd, Portland, OR 97212-3732 | 2019-02-06 |
| 1326531666 | Working Class Medicine LLC | Clinic/Center | 2133 N. Willis Blvd, Studio D, Portland, OR 97217 | 2018-06-12 |
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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.