MEDICARE: BARBARA SUZZANNE ERNSDORFF

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	171M00000X	Case Manager/Care Coordinator
2	390200000X	Student in an Organized Health Care Education/Training Program
3	175T00000X	Peer Specialist

General Provider Information

NPI Number	:	1508052481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA SUZZANNE ERNSDORFF

Provider Business Mailing Address
First Line	:	2995 RYAN DR SE
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97301-5157
Country	:	US
Telephone Number	:	503-371-7701
Fax Number	:

Provider Business Practice Location Address
First Line	:	2995 RYAN DR SE STE 200
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97301-5157
Country	:	US
Telephone Number	:	503-371-7701
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2007
Last Update Date	:	04/16/2025

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