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NPI Code Detail

MEDICARE: SETH S TEIGE

MEDICARE: SETH S TEIGE
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1093086076
Entity Type Code : Individual
Provider Name (Legal Business Name) : SETH S TEIGE
Provider Business Mailing Address
First Line : 14600 NW CORNELL RD
Second Line :
City : PORTLAND
State : OR
Zip : 97229-5442
Country : US
Telephone Number : 503-645-9581
Fax Number :
Provider Business Practice Location Address
First Line : 10714 NE GLISAN ST
Second Line :
City : PORTLAND
State : OR
Zip : 97220-4046
Country : US
Telephone Number : 503-256-2453
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2012
Last Update Date : 01/23/2012

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Directions to “ SETH S TEIGE ” Practice Location

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