Healthcare Provider Details

I. General information

NPI: 1740118025
Provider Name (Legal Business Name): ALIGN YOUR DESIGN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 SE GLENCOE PL
BEND OR
97702-1695
US

IV. Provider business mailing address

70 SW CENTURY DR STE 100
BEND OR
97702-3558
US

V. Phone/Fax

Practice location:
  • Phone: 541-526-3175
  • Fax:
Mailing address:
  • Phone: 541-526-3175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: KRIS PROCHASKA
Title or Position: OWNER
Credential: MA, LPC
Phone: 541-526-3175