MEDICARE: LAUREN K SAVILLE

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	R4374	OR
2	101YM0800X	Mental Health Counselor	C5949	OR

General Provider Information

NPI Number	:	1760835862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN K SAVILLE

Provider Business Mailing Address
First Line	:	3943 SE MADISON ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97214-4421
Country	:	US
Telephone Number	:	503-610-2691
Fax Number	:

Provider Business Practice Location Address
First Line	:	3943 SE MADISON ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97214-4421
Country	:	US
Telephone Number	:	503-610-2691
Fax Number	:

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

Provider Enumeration Date	:	07/13/2016
Last Update Date	:	12/01/2020

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Directions to “ LAUREN K SAVILLE ” Practice Location

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