MEDICARE: EILEEN L SALSIG MA

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	101YM0800X	Mental Health Counselor		OR
2	101YM0800X	Mental Health Counselor	R8275	OR

General Provider Information

NPI Number	:	1235832429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EILEEN L SALSIG MA

Provider Business Mailing Address
First Line	:	1612 5TH ST
Second Line	:
City	:	LA GRANDE
State	:	OR
Zip	:	97850-2516
Country	:	US
Telephone Number	:	541-809-1669
Fax Number	:

Provider Business Practice Location Address
First Line	:	1612 5TH ST
Second Line	:
City	:	LA GRANDE
State	:	OR
Zip	:	97850-2516
Country	:	US
Telephone Number	:	541-809-1669
Fax Number	:

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

Provider Enumeration Date	:	03/24/2023
Last Update Date	:	03/24/2023

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Directions to “ EILEEN L SALSIG MA” Practice Location

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