Healthcare Provider Details

I. General information

NPI: 1578220877
Provider Name (Legal Business Name): TEMENOS BEND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2021
Last Update Date: 10/17/2022
Certification Date: 10/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

376 SW BLUFF DR STE 5
BEND OR
97702-1399
US

IV. Provider business mailing address

1092 NW FEDERAL ST
BEND OR
97703-2341
US

V. Phone/Fax

Practice location:
  • Phone: 206-250-7002
  • Fax:
Mailing address:
  • Phone: 541-321-0972
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ELIZABETH MARLOWE PAIGE
Title or Position: OWNER
Credential: LCSW
Phone: 541-321-0972