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General NPI Number Information
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NPI Number | 1043059454
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Entity Type | Organization
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Legal Business Name | EASTERN OREGON HEALTH & WELLNESS INC
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Dates
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Enumeration Date | 05/23/2024
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 1501 6TH ST
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City | LA GRANDE
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State | OR
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Zip | 97850-2419
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Country | US
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Telephone | 541-805-2626
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Fax | 541-624-6005
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Provider Business Mailing Address
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Address Line | PO BOX 975
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City | LA GRANDE
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State | OR
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Zip | 97850-0975
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Country | US
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Telephone | 541-805-2626
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Fax | 541-605-6005
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. MICHELLE YVONNE FRIZZELL
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Credential | CADCII, CRM
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Telephone | 541-910-5577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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