Healthcare Provider Details

I. General information

NPI: 1013840735
Provider Name (Legal Business Name): LORI A FLETCHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20985 SCOTTSDALE DR
BEND OR
97701-7677
US

IV. Provider business mailing address

20985 SCOTTSDALE DR
BEND OR
97701-7677
US

V. Phone/Fax

Practice location:
  • Phone: 541-213-5052
  • Fax:
Mailing address:
  • Phone: 541-213-5052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: