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NPI Code Detail

MEDICARE: KATHRYN LYNN MARK

MEDICARE: KATHRYN LYNN MARK
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1205782521
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN LYNN MARK
Provider Business Mailing Address
First Line : 687 CHESHIRE AVE
Second Line :
City : EUGENE
State : OR
Zip : 97402-5060
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 687 CHESHIRE AVE
Second Line :
City : EUGENE
State : OR
Zip : 97402-5060
Country : US
Telephone Number : 541-684-4100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2026
Last Update Date : 03/09/2026

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Directions to “ KATHRYN LYNN MARK ” Practice Location

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