Provider Demographics
NPI:1326870130
Name:FOREMAN, RYLEE DAWN (LMT)
Entity type:Individual
Prefix:MS
First Name:RYLEE
Middle Name:DAWN
Last Name:FOREMAN
Suffix:
Gender:
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 HAVANA AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-7717
Mailing Address - Country:US
Mailing Address - Phone:541-324-8216
Mailing Address - Fax:
Practice Address - Street 1:108 S MARKET ST
Practice Address - Street 2:
Practice Address - City:TALENT
Practice Address - State:OR
Practice Address - Zip Code:97540-0266
Practice Address - Country:US
Practice Address - Phone:541-324-8216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR28392225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist