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NPI Code Detail

MEDICARE: MICHELLE BUTLER MA

MEDICARE:   MICHELLE  BUTLER  MA
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 CounselorR6807OR

General Provider Information

NPI Number : 1316396054
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE BUTLER MA
Provider Business Mailing Address
First Line : 272 NW MEDICAL LOOP
Second Line :
City : ROSEBURG
State : OR
Zip : 97471-5597
Country : US
Telephone Number : 541-900-4285
Fax Number :
Provider Business Practice Location Address
First Line : 272 NW MEDICAL LOOP
Second Line :
City : ROSEBURG
State : OR
Zip : 97471-5597
Country : US
Telephone Number : 541-900-4285
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2016
Last Update Date : 03/22/2021

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Directions to “ MICHELLE BUTLER MA” Practice Location

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