Soam Medical & Wellness

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

SOAM MEDICAL & WELLNESS

Practice address

801 E Main St Ste 100
Medford, OR 97504-7169

Phone

(541) 779-5235

NPI assigned

May 31, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brent M Kenyon

Title

Owner

Phone

(541) 291-6910

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1717113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717113600000",
    "number": "1922848357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 E MAIN ST STE 100",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047169",
            "telephone_number": "541-779-5235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E MAIN ST STE 100",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047169",
            "telephone_number": "541-779-5235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOAM MEDICAL & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-31",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A",
        "authorized_official_last_name": "KENYON",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-291-6910"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberley Danielle Snow
• Rikki Snowden
• Chyna Chanel Snyder
• Dean Snyder, M.D.
• Madalyn H Snyder
• Corona Sodemann
• Julia Lawrance Soderstrom
• Marie Pascale Soderstrom, M.S.,SLP
• Dominik Grzegorz Sokalski, M.D.
• Justina Sokolovas, PHARMD

• Multi-Specialty Clinic/Center in Medford, OR
• Providers in Medford, OR by specialty
• Multi-Specialty Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.