Healthcare Provider Details

I. General information

NPI: 1932056793
Provider Name (Legal Business Name): JOSHUA CLARAVALL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20744 SE IRON HORSE LN
BEND OR
97702-3850
US

IV. Provider business mailing address

12725 SW MILLIKAN WAY STE 300
BEAVERTON OR
97005-1687
US

V. Phone/Fax

Practice location:
  • Phone: 818-939-7097
  • Fax:
Mailing address:
  • Phone: 971-246-5970
  • 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: