Suzanne Ponsioen Therapy Llc | |
328 W Broadway Eugene OR 97401-2826 | |
(541) 653-2958 | |
(541) 610-1760 |
Full Name | Suzanne Ponsioen Therapy Llc |
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Speciality | Marriage & Family Therapist |
Location | 328 W Broadway, Eugene, Oregon |
Authorized Official Name and Position | Suzanne M Ponsioen (SOLE OWNER & PROVIDER) |
Authorized Official Contact | 5416532958 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Suzanne Ponsioen Therapy Llc 328 W Broadway Eugene OR 97401-2826 Ph: (541) 653-2958 | Suzanne Ponsioen Therapy Llc 328 W Broadway Eugene OR 97401-2826 Ph: (541) 653-2958 |
NPI Number | 1588200588 |
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Provider Enumeration Date | 11/25/2019 |
Last Update Date | 02/09/2024 |
Certification Date | 02/09/2024 |
Medicare PECOS PAC ID | 8921443292 |
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Medicare Enrollment ID | O20240226003533 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588200588 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
Provider Name | Suzanne M Ponsioen |
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Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1831309293 PECOS PAC ID: 0749625010 Enrollment ID: I20240226003578 |
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