Healthcare Provider Details

I. General information

NPI: 1417888207
Provider Name (Legal Business Name): LAURA MICHELLE HORNSTEIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 CASCADE DR
LEBANON OR
97355-3721
US

IV. Provider business mailing address

550 CASCADE DR
LEBANON OR
97355-3721
US

V. Phone/Fax

Practice location:
  • Phone: 541-451-8416
  • Fax:
Mailing address:
  • Phone: 541-451-8416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number528670
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: