Healthcare Provider Details

I. General information

NPI: 1528882883
Provider Name (Legal Business Name): LONDY MARIBEL SEIDEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2024
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 HILYARD ST STE 570
EUGENE OR
97401-8168
US

IV. Provider business mailing address

1020 E 26TH AVE
EUGENE OR
97405-4108
US

V. Phone/Fax

Practice location:
  • Phone: 458-205-7070
  • Fax:
Mailing address:
  • Phone: 971-266-7889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
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:
Title or Position:
Credential:
Phone: