Healthcare Provider Details

I. General information

NPI: 1235516089
Provider Name (Legal Business Name): CHELSIE CIERRA HUTSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2015
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73265 CONFEDERATED WAY
PENDLETON OR
97801-9099
US

IV. Provider business mailing address

46314 TIMINE WAY
PENDLETON OR
97801-9417
US

V. Phone/Fax

Practice location:
  • Phone: 541-701-4732
  • Fax:
Mailing address:
  • Phone: 541-701-4732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number20060005127
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2006005127
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: