Provider Demographics
NPI:1124413570
Name:SULZER, ASHTON (LMT)
Entity Type:Individual
Prefix:
First Name:ASHTON
Middle Name:
Last Name:SULZER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:SULZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:870 22ND ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-4410
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1234 PEARL ST STE 6
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3642
Practice Address - Country:US
Practice Address - Phone:206-849-4724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-02
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27147225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist