| Pnw Trauma Counseling | |
|
750 Charbonneau Ste 204 Bend OR 97703-7047 | |
| (541) 275-5386 | |
| (541) 229-1311 |
| Full Name | Pnw Trauma Counseling |
|---|---|
| Speciality | Social Worker |
| Location | 750 Charbonneau Ste 204, Bend, Oregon |
| Authorized Official Name and Position | Suci Andrea Sonnier (OWNER) |
| Authorized Official Contact | 5412755386 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pnw Trauma Counseling 61141 S Hwy 97 Ste 422 Bend OR 97702-2523 Ph: (541) 275-5386 | Pnw Trauma Counseling 750 Charbonneau Ste 204 Bend OR 97703-7047 Ph: (541) 275-5386 |
| NPI Number | 1225643034 |
|---|---|
| Provider Enumeration Date | 09/09/2020 |
| Last Update Date | 12/22/2020 |
| Certification Date | 12/22/2020 |
| Medicare PECOS PAC ID | 3274953146 |
|---|---|
| Medicare Enrollment ID | O20201014001329 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225643034 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Suci Andrea Sonnier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982259933 PECOS PAC ID: 3072944016 Enrollment ID: I20200507002097 |
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