Healthcare Provider Details

I. General information

NPI: 1821238304
Provider Name (Legal Business Name): DEPARTMENT OF CHILDREN AND FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2009
Last Update Date: 02/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73239 CONFEDERATED WAY
PENDLETON OR
97801-9099
US

IV. Provider business mailing address

73239 CONFEDERATED WAY
PENDLETON OR
97801-9099
US

V. Phone/Fax

Practice location:
  • Phone: 541-966-2915
  • Fax:
Mailing address:
  • Phone: 541-966-2915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: MS. THERSA ELISOFF
Title or Position: DEPARTMENT DIRECTOR
Credential:
Phone: 541-966-2915