Healthcare Provider Details

I. General information

NPI: 1063687697
Provider Name (Legal Business Name): PEOPLE SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2008
Last Update Date: 12/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 S MAIN ST
LEBANON OR
97355-3210
US

IV. Provider business mailing address

PO BOX 280
LEBANON OR
97355-0280
US

V. Phone/Fax

Practice location:
  • Phone: 541-258-8210
  • Fax: 541-258-8212
Mailing address:
  • Phone: 541-258-8210
  • Fax: 541-258-8212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC1962
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS WESLEY AYALA
Title or Position: MANAGING PARTNER
Credential: PROF. COUNSELOR
Phone: 541-258-8210