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General NPI Number Information
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NPI Number | 1023931292
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Entity Type | Individual
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Provider Name | KATRINA LUCKY LEE FARRELL
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Gender | Female
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Dates
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Enumeration Date | 08/03/2026
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Last Update Date | 08/03/2026
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Provider Practice Location Address
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Address Line | 1720 W 25TH AVE
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City | EUGENE
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State | OR
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Zip | 97405-1694
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Country | US
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Telephone | 541-343-9706
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 MAIN ST APT 12
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City | SPRINGFIELD
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State | OR
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Zip | 97477-4924
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Country | US
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Telephone | 541-600-0238
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | OR
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