| Evergreen Therapy & Trauma Services | |
|
4380 Cherry Ave Ne Keizer OR 97303-4855 | |
| (971) 458-3064 | |
| Not Available |
| Full Name | Evergreen Therapy & Trauma Services |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4380 Cherry Ave Ne, Keizer, Oregon |
| Authorized Official Name and Position | Cassandra Aglietti (PRESIDENT) |
| Authorized Official Contact | 9714583064 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Therapy & Trauma Services 729 Crystal Springs Ln N Keizer OR 97303-3799 Ph: (971) 458-3064 | Evergreen Therapy & Trauma Services 4380 Cherry Ave Ne Keizer OR 97303-4855 Ph: (971) 458-3064 |
| NPI Number | 1992526065 |
|---|---|
| Provider Enumeration Date | 10/22/2024 |
| Last Update Date | 10/30/2024 |
| Certification Date | 10/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992526065 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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