Healthcare Provider Details

I. General information

NPI: 1659248409
Provider Name (Legal Business Name): EMILY GRACE HOUCK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2025
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 SHELTON MCMURPHEY BLVD
EUGENE OR
97401-4928
US

IV. Provider business mailing address

10 SHELTON MCMURPHEY BLVD
EUGENE OR
97401-4928
US

V. Phone/Fax

Practice location:
  • Phone: 541-485-2711
  • Fax: 541-485-7087
Mailing address:
  • Phone: 541-485-2711
  • Fax: 541-485-7087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number24-11-11306
License Number StateOR

VII. Legacy identifiers

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

# 1
Identifier24-11-11306
Identifier TypeOTHER
Identifier StateOR
Identifier IssuerMACHBO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: