Healthcare Provider Details

I. General information

NPI: 1235817453
Provider Name (Legal Business Name): SEEGOBIN PSYCHOLOGICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2023
Last Update Date: 07/07/2023
Certification Date: 07/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N VILLA RD
NEWBERG OR
97132-1818
US

IV. Provider business mailing address

414 N MERIDIAN ST # 6104
NEWBERG OR
97132-2697
US

V. Phone/Fax

Practice location:
  • Phone: 503-830-5381
  • Fax:
Mailing address:
  • Phone: 503-830-5381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: THERESE ZAIGER
Title or Position: BUS MANAGER/CREDENTIALING
Credential:
Phone: 503-364-6093