| Amy R Duryea Lcsw Llc | |
|
2432 Sw 35th Dr Redmond OR 97756-7862 | |
| (541) 204-0100 | |
| Not Available |
| Full Name | Amy R Duryea Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2432 Sw 35th Dr, Redmond, Oregon |
| Authorized Official Name and Position | Amy R Duryea (OWNER/PROVIDER) |
| Authorized Official Contact | 5412040100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amy R Duryea Lcsw Llc 2432 Sw 35th Dr Redmond OR 97756-7862 Ph: (541) 204-0100 | Amy R Duryea Lcsw Llc 2432 Sw 35th Dr Redmond OR 97756-7862 Ph: (541) 204-0100 |
| NPI Number | 1790384238 |
|---|---|
| Provider Enumeration Date | 10/24/2020 |
| Last Update Date | 08/11/2023 |
| Certification Date | 08/11/2023 |
| Medicare PECOS PAC ID | 2365833282 |
|---|---|
| Medicare Enrollment ID | O20220103000282 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790384238 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Amy R Duryea |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114474962 PECOS PAC ID: 3274924196 Enrollment ID: I20220103000307 |
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