| Lcsnw | |
|
435 Ne Evans St Ste A Mcminnville OR 97128-4635 | |
| (503) 472-4020 | |
| (503) 472-8630 |
| Full Name | Lcsnw |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 435 Ne Evans St Ste A, Mcminnville, Oregon |
| Authorized Official Name and Position | Shelia Clark (CREDENTIALING) |
| Authorized Official Contact | 5412013973 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lcsnw 435 Ne Evans St Ste A Mcminnville OR 97128-4635 Ph: (503) 472-4020 | Lcsnw 435 Ne Evans St Ste A Mcminnville OR 97128-4635 Ph: (503) 472-4020 |
| NPI Number | 1255542106 |
|---|---|
| Provider Enumeration Date | 05/24/2007 |
| Last Update Date | 02/13/2023 |
| Certification Date | 02/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255542106 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Secondary |
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