Healthcare Provider Details

I. General information

NPI: 1871552422
Provider Name (Legal Business Name): ELDON ARTHUR RICHEY LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2006
Last Update Date: 07/19/2023
Certification Date: 07/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2440 WILLAMETTE ST STE 201
EUGENE OR
97405-3170
US

IV. Provider business mailing address

2440 WILLAMETTE ST STE 201
EUGENE OR
97405-3170
US

V. Phone/Fax

Practice location:
  • Phone: 415-321-2278
  • Fax: 412-468-8265
Mailing address:
  • Phone: 415-321-2278
  • Fax: 412-468-8265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number8762
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: