MEDICARE: ASHLEY D REMIRO LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	T1581	OR

General Provider Information

NPI Number	:	1124374574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY D REMIRO LMFT

Provider Business Mailing Address
First Line	:	895 COUNTRY CLUB RD STE A140
Second Line	:
City	:	EUGENE
State	:	OR
Zip	:	97401-6028
Country	:	US
Telephone Number	:	541-844-4182
Fax Number	:

Provider Business Practice Location Address
First Line	:	895 COUNTRY CLUB RD STE A140
Second Line	:
City	:	EUGENE
State	:	OR
Zip	:	97401-6028
Country	:	US
Telephone Number	:	541-844-4182
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2012
Last Update Date	:	06/15/2022

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