Provider Demographics
NPI:1346930849
Name:RADEMACHER, ELIAS DANIEL
Entity type:Individual
Prefix:
First Name:ELIAS
Middle Name:DANIEL
Last Name:RADEMACHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1229 MAIN ST
Mailing Address - Street 2:#101
Mailing Address - City:PHILOMATH
Mailing Address - State:OR
Mailing Address - Zip Code:97370
Mailing Address - Country:US
Mailing Address - Phone:541-740-6589
Mailing Address - Fax:
Practice Address - Street 1:1229 MAIN ST.
Practice Address - Street 2:#101
Practice Address - City:PHILOMATH
Practice Address - State:OR
Practice Address - Zip Code:97370
Practice Address - Country:US
Practice Address - Phone:541-740-6589
Practice Address - Fax:541-929-3052
Is Sole Proprietor?:No
Enumeration Date:2023-05-09
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health