Provider Demographics
NPI:1013318120
Name:FRIEDMAN, LOREN MICHAEL (LMT)
Entity Type:Individual
Prefix:
First Name:LOREN
Middle Name:MICHAEL
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 W 7TH AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402
Mailing Address - Country:US
Mailing Address - Phone:541-286-5455
Mailing Address - Fax:541-484-2128
Practice Address - Street 1:825 W 7TH AVE
Practice Address - Street 2:SUITE A
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402
Practice Address - Country:US
Practice Address - Phone:541-286-5455
Practice Address - Fax:541-484-2225
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-08
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR18216225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist