Healthcare Provider Details

I. General information

NPI: 1366995862
Provider Name (Legal Business Name): COLLEEN COMEAU PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: COLLEEN JAMES PSYD

II. Dates (important events)

Enumeration Date: 08/01/2016
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 WILLAMETTE ST STE 230
EUGENE OR
97401-3129
US

IV. Provider business mailing address

940 WILLAMETTE ST STE 230
EUGENE OR
97401-3129
US

V. Phone/Fax

Practice location:
  • Phone: 541-357-9764
  • Fax:
Mailing address:
  • Phone: 541-357-9764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number3130
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: