Healthcare Provider Details

I. General information

NPI: 1912185752
Provider Name (Legal Business Name): LINDA ESTHER HOGGAN LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2008
Last Update Date: 02/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 N BARTLETT ST
MEDFORD OR
97501-6013
US

IV. Provider business mailing address

1217 MURRAY ST
MEDFORD OR
97501-3204
US

V. Phone/Fax

Practice location:
  • Phone: 541-245-2950
  • Fax:
Mailing address:
  • Phone: 541-245-2950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number3879
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: