Healthcare Provider Details

I. General information

NPI: 1235814591
Provider Name (Legal Business Name): ABIGAIL SUSANA GRIEGO LPC- ASSOCIATE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2023
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2645 PORTLAND RD NE STE 120
SALEM OR
97301-0200
US

IV. Provider business mailing address

360 E 10TH AVE STE 450
EUGENE OR
97401-5599
US

V. Phone/Fax

Practice location:
  • Phone: 503-390-5637
  • Fax: 503-393-3135
Mailing address:
  • Phone: 541-687-6983
  • Fax: 541-684-7638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: