Healthcare Provider Details

I. General information

NPI: 1558037671
Provider Name (Legal Business Name): AMANDA BUEFFEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2021
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 NE IRVING ST STE 440
PORTLAND OR
97232-4208
US

IV. Provider business mailing address

1531 PEARL ST
EUGENE OR
97401-4010
US

V. Phone/Fax

Practice location:
  • Phone: 541-517-9733
  • Fax:
Mailing address:
  • Phone: 541-517-9733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberT2857
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: