MEDICARE: DEANNA PADGET

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	101YM0800X	Mental Health Counselor	R9975	OR
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1124705868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEANNA PADGET

Provider Business Mailing Address
First Line	:	9582 HILL RD
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97603-9729
Country	:	US
Telephone Number	:	541-505-4468
Fax Number	:

Provider Business Practice Location Address
First Line	:	9582 HILL RD
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97603-9729
Country	:	US
Telephone Number	:	541-887-0136
Fax Number	:

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

Provider Enumeration Date	:	07/04/2023
Last Update Date	:	03/24/2025

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Directions to “ DEANNA PADGET ” Practice Location

Language	Start Address	Practice Location

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