Healthcare Provider Details
I. General information
NPI: 1720518251
Provider Name (Legal Business Name): MR. RHYS RUTGERS CONGER
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/18/2017
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1755 COBURG RD UNIT 301
EUGENE OR
97401-4900
US
IV. Provider business mailing address
PO BOX 772
SPRINGFIELD OR
97477-0132
US
V. Phone/Fax
- Phone: 541-632-4850
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | R8923 |
| License Number State | OR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: