Healthcare Provider Details

I. General information

NPI: 1003474081
Provider Name (Legal Business Name): SYDNEY A TOSTENSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2019
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1790 W 11TH AVE STE 200
EUGENE OR
97402-3871
US

IV. Provider business mailing address

1030 W 11TH AVE APT 2
EUGENE OR
97402-7761
US

V. Phone/Fax

Practice location:
  • Phone: 541-686-2688
  • Fax:
Mailing address:
  • Phone: 541-315-5277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: