Individual ProviderEmanuelle GomezSocial WorkerBehavioral Health & Social Service ProvidersPractice Address233 4th St, Ashland, OR 97520-2043(541) 301-7414PECOS EnrollmentBased on the most recent information from CMS, provider Emanuelle Gomez is legally eligible to order and refer claims for Part B and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1053648188Provider TypeIndividualFull NameGomez, EmanuelleTitleMrs.CredentialLCSWGenderFemaleSole ProprietorYesEnumeration Date11/10/2009Last Updated12/20/2022Contact InformationPractice LocationPractice Address233 4th St, Ashland, OR 97520-2043Phone(541) 301-7414FaxUnlisted FaxMailing LocationMailing AddressPO Box 503010, White City, OR 97503-0813Phone(541) 301-7414Fax(503) 419-4662Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense4432Oregon