MEDICARE: ZACHARY ALLEN FERRIS MA LPC

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	101YP2500X	Professional Counselor	C8805	OR

General Provider Information

NPI Number	:	1730809542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZACHARY ALLEN FERRIS MA LPC

Provider Business Mailing Address
First Line	:	2570 NW EDENBOWER BLVD STE 100
Second Line	:
City	:	ROSEBURG
State	:	OR
Zip	:	97471-6214
Country	:	US
Telephone Number	:	541-677-7200
Fax Number	:	541-229-3309

Provider Business Practice Location Address
First Line	:	249 DAKOTA ST
Second Line	:
City	:	SUTHERLIN
State	:	OR
Zip	:	97479-9908
Country	:	US
Telephone Number	:	541-677-7200
Fax Number	:	541-229-3309

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

Provider Enumeration Date	:	08/31/2022
Last Update Date	:	10/22/2024

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Directions to “ ZACHARY ALLEN FERRIS MA LPC” Practice Location

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