Healthcare Provider Details

I. General information

NPI: 1578149928
Provider Name (Legal Business Name): WEST COAST WELLNESS CENTER FOR HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 03/14/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4175 E AMAZON DR
EUGENE OR
97405-4660
US

IV. Provider business mailing address

4175 E AMAZON DR
EUGENE OR
97405-4660
US

V. Phone/Fax

Practice location:
  • Phone: 541-632-4014
  • Fax: 855-433-4124
Mailing address:
  • Phone: 541-632-4014
  • Fax: 855-433-4124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
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: RACHEL CAZAVILAN
Title or Position: OWNER/THERAPIST
Credential: LPC
Phone: 541-632-4014