MEDICARE: CONCEPCION MARIN CUELLAR

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	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor
3	101YP2500X	Professional Counselor	C5322	OR

General Provider Information

NPI Number	:	1295283117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONCEPCION MARIN CUELLAR

Provider Business Mailing Address
First Line	:	1900 NE HIGHWAY 99W STE F
Second Line	:
City	:	MCMINNVILLE
State	:	OR
Zip	:	97128-2757
Country	:	US
Telephone Number	:	503-437-6510
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 NE HIGHWAY 99W STE F
Second Line	:
City	:	MCMINNVILLE
State	:	OR
Zip	:	97128-2757
Country	:	US
Telephone Number	:	503-437-6510
Fax Number	:

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

Provider Enumeration Date	:	09/20/2016
Last Update Date	:	08/21/2025

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Directions to “ CONCEPCION MARIN CUELLAR ” Practice Location

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