Mandy R Prestenbach

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

635 Russell Dr
Lebanon, OR 97355-3881

Phone

(541) 990-3465

NPI assigned

Nov 5, 2024

Last updated

Nov 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1316760523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 RUSSELL DR",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973553881",
            "telephone_number": "541-990-3465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 RUSSELL DR",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973553881",
            "telephone_number": "541-990-3465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTENBACH",
        "first_name": "MANDY",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Jean Prawitz-Wiprud, DO
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• Premise Health of Oregon Medical P C (My Health Center At Lowe's Lebanon)
• Sean Joseph Prendergast
• Charles Price, DO
• Garrett Price, PHARMD
• Rosita Rodriguez Proteau, PH.D., R.PH.
• PT Acquisitions LLC (PT Mobile)
• Sarah Elizabeth Quewakum, PMHNP-BC

• Counselor in Lebanon, OR
• Providers in Lebanon, OR by specialty
• Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.