Ron Vanausdal, LCSW | |
702 Sunset Dr, Ontario, OR 97914-3121 | |
(541) 889-9167 | |
(541) 889-7873 |
Full Name | Ron Vanausdal |
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Gender | Male |
Speciality | Social Worker - Clinical |
Location | 702 Sunset Dr, Ontario, Oregon |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1275956880 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | LCSW-35711 (Idaho) | Secondary |
1041C0700X | Social Worker - Clinical | L7036 (Oregon) | Primary |
Entity Name | Lifeways Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1568558955 PECOS PAC ID: 4183696214 Enrollment ID: O20140410000839 |
Mailing Address | Practice Location Address |
---|---|
Ron Vanausdal, LCSW 16204 Beckley Ct, Nampa, ID 83687-8340 Ph: (208) 602-1364 | Ron Vanausdal, LCSW 702 Sunset Dr, Ontario, OR 97914-3121 Ph: (541) 889-9167 |
Genelle Jo Mackey, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 685 N Oregon St, Ontario, OR 97914 Phone: 541-889-2219 | |
Timothy L Koberlein, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 702 Sunset Dr, Ontario, OR 97914 Phone: 541-889-9167 Fax: 541-889-7873 | |
Sarah Andrade, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 702 Sunset Dr, Ontario, OR 97914 Phone: 541-889-9167 Fax: 541-889-7873 | |
J. Harrison Whitcomb, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 702 Sunset Dr, Ontario, OR 97914 Phone: 541-889-9167 | |
Ms. Janette Lynn Pennington, CSWA Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1219 Sw 4th Ave, Ontario, OR 97914 Phone: 541-889-2668 | |
Mrs. Jessica Carpenter, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 702 Sunset Dr, Ontario, OR 97914 Phone: 541-889-9167 Fax: 541-881-1503 |