Individual
MS. SUSAN M OLDLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1755 COBURG RD, BLDG 4, STE 2, EUGENE, OR 97401-4982
(541) 684-3988
Mailing address
86451 FRANKLIN BLVD, EUGENE, OR 97405-9642
(541) 744-8944
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
14948
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14948
MASSAGE LICENSE
OR
Enumeration date
06/10/2008
Last updated
06/10/2008
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