Paul Henry Van Egmond, QMHA
Individual provider Active NPI Counselor · Ontario, OR
NPI 1235259581 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1235259581
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 702 Sunset Dr
Ontario, OR 97914-3121 - Phone
- (541) 889-9167
- Fax
- (541) 889-7873
- NPI assigned
- Mar 30, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
702 Sunset Dr
Ontario, OR 97914-3121
Mailing address
702 Sunset Dr
Ontario, OR 97914-3121
Phone (541) 889-9167
Other providers in Ontario, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.