Healthcare Provider Details

I. General information

NPI: 1497377188
Provider Name (Legal Business Name): LOIS MICHAUD, PH.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2020
Last Update Date: 05/15/2020
Certification Date: 05/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 LAWRENCE ST STE 106
EUGENE OR
97401-2586
US

IV. Provider business mailing address

570 LAWRENCE ST STE 106
EUGENE OR
97401-2586
US

V. Phone/Fax

Practice location:
  • Phone: 541-246-8661
  • Fax: 541-359-1564
Mailing address:
  • Phone: 541-246-8661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
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: DR. LOIS IRENE MICHAUD
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 541-246-8661