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General NPI Number Information
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NPI Number | 1588788772
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Entity Type | Individual
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Provider Name | PATRICIA DOEMLAND OR LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 02/15/2026
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Provider Practice Location Address
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Address Line | 724 CARDLEY AVE
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City | MEDFORD
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State | OR
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Zip | 97504-6124
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Country | US
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Telephone | 541-840-3714
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Fax | 206-784-2739
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Provider Business Mailing Address
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Address Line | 917 N 200TH ST #404
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City | SHORELINE
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State | WA
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Zip | 98133-3147
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Country | US
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Telephone | 541-840-3714
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Fax | 206-784-2739
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1512
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License Number State | OR
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