| Fernreach, Llc. | |
|
304 S 13th St Cottage Grove OR 97424-2315 | |
| (458) 201-4911 | |
| (541) 228-9370 |
| Full Name | Fernreach, Llc. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 304 S 13th St, Cottage Grove, Oregon |
| Authorized Official Name and Position | Valeria Clarke (OWNER) |
| Authorized Official Contact | 5419152690 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fernreach, Llc. 314 S 13th St Cottage Grove OR 97424-2315 Ph: (541) 915-2690 | Fernreach, Llc. 304 S 13th St Cottage Grove OR 97424-2315 Ph: (458) 201-4911 |
| NPI Number | 1952048977 |
|---|---|
| Provider Enumeration Date | 05/20/2022 |
| Last Update Date | 05/20/2022 |
| Certification Date | 05/20/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952048977 | NPI | - | NPPES |
| 019047 | Medicaid | OR | |
| 500660349 | Other | OR | DMAP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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