| Dr. Trace Wonser | |
|
501 Main St Ste 307 Klamath Falls OR 97601-6049 | |
| (541) 892-0518 | |
| Not Available |
| Full Name | Dr. Trace Wonser |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 501 Main St Ste 307, Klamath Falls, Oregon |
| Authorized Official Name and Position | Tracy Wonser (OPERATOR) |
| Authorized Official Contact | 5418920518 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Trace Wonser 501 Main St Ste 307 Klamath Falls OR 97601-6049 Ph: (541) 892-0518 | Dr. Trace Wonser 501 Main St Ste 307 Klamath Falls OR 97601-6049 Ph: (541) 892-0518 |
| NPI Number | 1720869688 |
|---|---|
| Provider Enumeration Date | 10/06/2023 |
| Last Update Date | 01/10/2024 |
| Certification Date | 01/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720869688 | NPI | - | NPPES |
| 500715374 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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