Lance Nelson, | |
420 Ne 5th St, Mcminnville, OR 97128-4603 | |
(503) 434-7462 | |
Not Available |
Full Name | Lance Nelson |
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Gender | Male |
Speciality | Counselor - Mental Health |
Location | 420 Ne 5th St, Mcminnville, Oregon |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1609012897 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Entity Name | Waterfall Clinic Incorporated |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1619915113 PECOS PAC ID: 5698740355 Enrollment ID: O20040827000153 |
Mailing Address | Practice Location Address |
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Lance Nelson, 420 Ne 5th St, Mcminnville, OR 97128-4603 Ph: (503) 434-7462 | Lance Nelson, 420 Ne 5th St, Mcminnville, OR 97128-4603 Ph: (503) 434-7462 |
Susie Margaret Alin, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 707 Ne 5th St, Mcminnville, OR 97128 Phone: 971-237-2324 | |
Maya K Benham, Counselor Medicare: Not Enrolled in Medicare Practice Location: 800 Ne 2nd St, Mcminnville, OR 97128 Phone: 503-472-2240 | |
Traci Ramirez, Counselor Medicare: Not Enrolled in Medicare Practice Location: 627 Ne Evans St, Mcminnville, OR 97128 Phone: 503-434-7523 | |
Paul Studebaker, Counselor Medicare: Not Enrolled in Medicare Practice Location: 627 Ne Evans St, Mcminnville, OR 97128 Phone: 503-434-7523 | |
Rene Delgado, Counselor Medicare: Not Enrolled in Medicare Practice Location: 627 Ne Evans St, Mcminnville, OR 97128 Phone: 503-434-7523 Fax: 503-434-9846 | |
Valeria Atanacio, Counselor Medicare: Not Enrolled in Medicare Practice Location: 627 Ne Evans St, Mcminnville, OR 97128 Phone: 503-434-7523 | |
Estenio Eliezer Sede Eduardo, Counselor Medicare: Not Enrolled in Medicare Practice Location: 435 Ne Evans St Ste A, Mcminnville, OR 97128 Phone: 503-472-4020 |