Healthcare Provider Details

I. General information

NPI: 1396778338
Provider Name (Legal Business Name): A. DEL QUEST LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2149 CENTENNIAL PLZ STE 4
EUGENE OR
97401-2456
US

IV. Provider business mailing address

78 CENTENNIAL LOOP STE A
EUGENE OR
97401-7900
US

V. Phone/Fax

Practice location:
  • Phone: 541-741-7107
  • Fax: 541-687-9279
Mailing address:
  • Phone: 541-393-0777
  • Fax: 541-687-9279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL4608
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierL4608
Identifier TypeOTHER
Identifier StateOR
Identifier IssuerSOCIAL WORK LICENSE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: