Healthcare Provider Details
I. General information
NPI: 1013341023
Provider Name (Legal Business Name): CHARLENE SEATON CADC-R
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/27/2013
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1050 HIGH ST
EUGENE OR
97401-3240
US
IV. Provider business mailing address
687 CHESHIRE AVE
EUGENE OR
97402-5060
US
V. Phone/Fax
- Phone: 541-762-4300
- Fax:
- Phone: 541-762-7575
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | T-19-279 |
| License Number State | OR |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: