Healthcare Provider Details

I. General information

NPI: 1063604858
Provider Name (Legal Business Name): JAMES E SAXTON LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2007
Last Update Date: 06/17/2022
Certification Date: 06/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

916 SW 17TH ST STE 202
REDMOND OR
97756-2572
US

IV. Provider business mailing address

PO BOX 5579
BEND OR
97708-5579
US

V. Phone/Fax

Practice location:
  • Phone: 541-706-2768
  • Fax:
Mailing address:
  • Phone: 541-706-2768
  • Fax: 541-706-4760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL2606
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: