Healthcare Provider Details

I. General information

NPI: 1831384940
Provider Name (Legal Business Name): MARY ELIZABETH JAMES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY E DEHAMER M.A., LMFT

II. Dates (important events)

Enumeration Date: 09/11/2007
Last Update Date: 11/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2411 MARTIN LUTHER KING JR. BLVD.
EUGENE OR
97401
US

IV. Provider business mailing address

2073 OLYMPIC ST.
SPRINGFIELD OR
97477
US

V. Phone/Fax

Practice location:
  • Phone: 541-682-3608
  • Fax:
Mailing address:
  • Phone: 541-682-3550
  • Fax: 626-585-1664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number51983
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: