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General NPI Number Information
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NPI Number | 1538607106
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Entity Type | Individual
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Provider Name | JENNIFER D SCHNELL LMT#20190
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Gender | Female
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Dates
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Enumeration Date | 02/03/2017
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Last Update Date | 07/22/2022
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Provider Practice Location Address
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Address Line | 155 ALTA VISTA RD STE B
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City | EAGLE POINT
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State | OR
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Zip | 97524-9735
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Country | US
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Telephone | 541-879-3443
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Fax |
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Provider Business Mailing Address
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Address Line | 516 MARY ST
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City | MEDFORD
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State | OR
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Zip | 97504-6828
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Country | US
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Telephone | 541-499-2272
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 20190
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License Number State | OR
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