Healthcare Provider Details

I. General information

NPI: 1780942425
Provider Name (Legal Business Name): MR. RICHARD SEIGLER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2012
Last Update Date: 09/22/2020
Certification Date: 09/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 SW FRAZER AVE STE 102
PENDLETON OR
97801-2800
US

IV. Provider business mailing address

24 NW 10TH ST
PENDLETON OR
97801-1520
US

V. Phone/Fax

Practice location:
  • Phone: 971-308-4587
  • Fax: 971-220-9883
Mailing address:
  • Phone: 971-308-4587
  • Fax: 971-220-9883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLF60952315
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2605-R
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberT1509
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: