Provider Demographics
NPI:1003513813
Name:COUNTS, CAROLINE (LMT)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:COUNTS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 PLUM ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-3000
Mailing Address - Country:US
Mailing Address - Phone:541-660-1362
Mailing Address - Fax:
Practice Address - Street 1:425 PLUM ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-3000
Practice Address - Country:US
Practice Address - Phone:541-660-1362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR22434OtherOREGON BOARD OF MASSAGE