Healthcare Provider Details

I. General information

NPI: 1912355827
Provider Name (Legal Business Name): REBECCA ALEXANDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2016
Last Update Date: 11/29/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 W 8TH AVE STE 300
EUGENE OR
97401-2997
US

IV. Provider business mailing address

115 W 8TH AVE STE 300
EUGENE OR
97401-2997
US

V. Phone/Fax

Practice location:
  • Phone: 541-505-8168
  • Fax:
Mailing address:
  • Phone: 541-505-8168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC4769
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional 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: