MEDICARE: WESLEY LOUIS LOBDELL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor		OR

General Provider Information

NPI Number	:	1073464558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WESLEY LOUIS LOBDELL

Provider Business Mailing Address
First Line	:	2210 N ELDORADO AVE
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601-6418
Country	:	US
Telephone Number	:	541-883-1030
Fax Number	:	541-884-2338

Provider Business Practice Location Address
First Line	:	2210 N ELDORADO AVE
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601-6418
Country	:	US
Telephone Number	:	541-883-1030
Fax Number	:	541-884-2338

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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Directions to “ WESLEY LOUIS LOBDELL ” Practice Location

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