Provider Demographics
NPI:1225177306
Name:FROEHLICH, SUSAN E (LAC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:E
Last Name:FROEHLICH
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 E. 2ND
Mailing Address - Street 2:PO BOX 312
Mailing Address - City:MOSIER
Mailing Address - State:OR
Mailing Address - Zip Code:97040
Mailing Address - Country:US
Mailing Address - Phone:541-806-6767
Mailing Address - Fax:
Practice Address - Street 1:700 E PORT MARINA DR STE 100
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-2380
Practice Address - Country:US
Practice Address - Phone:541-386-8767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00478171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist