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NPI Code Detail

MEDICARE: LOURDES C VILLAGRAN

MEDICARE: LOURDES C VILLAGRAN
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 CounselorOR

General Provider Information

NPI Number : 1568956050
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOURDES C VILLAGRAN
Provider Business Mailing Address
First Line : 1705 CENTENNIAL BLVD STE 2
Second Line :
City : SPRINGFIELD
State : OR
Zip : 97477-3320
Country : US
Telephone Number : 541-818-0009
Fax Number :
Provider Business Practice Location Address
First Line : 9620 NE TANASBOURNE DR STE 300
Second Line :
City : HILLSBORO
State : OR
Zip : 97124-7844
Country : US
Telephone Number : 858-375-8469
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2018
Last Update Date : 08/11/2023

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Directions to “ LOURDES C VILLAGRAN ” Practice Location

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