Provider Demographics
NPI:1871016758
Name:MERRIMAN, JOAN M I (LMT)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:M
Last Name:MERRIMAN
Suffix:I
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 1:1430 WILLAMETTE ST # 140
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4049
Mailing Address - Country:US
Mailing Address - Phone:541-632-3565
Mailing Address - Fax:
Practice Address - Street 1:351 W 12TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3410
Practice Address - Country:US
Practice Address - Phone:541-632-3565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-21
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR19409225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist