Healthcare Provider Details

I. General information

NPI: 1275973182
Provider Name (Legal Business Name): IRENE COFFMAN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: IRENE D MEEKER LMFT

II. Dates (important events)

Enumeration Date: 06/25/2013
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W MAIN ST STE 4E
MEDFORD OR
97501-2744
US

IV. Provider business mailing address

201 W MAIN ST STE 4E
MEDFORD OR
97501-2744
US

V. Phone/Fax

Practice location:
  • Phone: 541-281-9026
  • Fax: 541-635-2087
Mailing address:
  • Phone: 541-281-9026
  • Fax: 541-635-2087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberT2005
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: