Provider Demographics
NPI:1699217455
Name:FIFIELD, ELIZABETH MICHELLE (LMT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MICHELLE
Last Name:FIFIELD
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:MICHELLE
Other - Last Name:JUAREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:P.O. BOX 40771
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404
Mailing Address - Country:US
Mailing Address - Phone:541-344-4788
Mailing Address - Fax:877-699-5228
Practice Address - Street 1:2485 WEST 7TH PLACE
Practice Address - Street 2:SUITE 1
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402
Practice Address - Country:US
Practice Address - Phone:541-344-4788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-10
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR18384225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR18384OtherLMT