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850 Siskiyou Blvd Suite 9 Ashland OR 97520-2125 | |
| (541) 482-2780 | |
| (541) 482-2780 |
| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 850 Siskiyou Blvd, Ashland, Oregon |
| Authorized Official Name and Position | Susan C Berryhill (CLINIC DIRECTOR) |
| Authorized Official Contact | 5414822780 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 1316 Ashland OR 97520-0044 Ph: () - | 850 Siskiyou Blvd Suite 9 Ashland OR 97520-2125 Ph: (541) 482-2780 |
| NPI Number | 1710150875 |
|---|---|
| Provider Enumeration Date | 04/10/2008 |
| Last Update Date | 04/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710150875 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | C0060 (Oregon) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Secondary |
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