MEDICARE: CHELSI MORAVETZ

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	R7764	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1427504	OTHER	OR	STATE ID

General Provider Information

NPI Number	:	1912635277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSI MORAVETZ

Provider Business Mailing Address
First Line	:	2141 NORTHEAST DIVISION ST. SUITE 101
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97701
Country	:	US
Telephone Number	:	541-241-3109
Fax Number	:

Provider Business Practice Location Address
First Line	:	2214 NE DIVISION ST STE 101
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97703-3551
Country	:	US
Telephone Number	:	541-241-3109
Fax Number	:

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

Provider Enumeration Date	:	08/12/2022
Last Update Date	:	08/12/2022

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Directions to “ CHELSI MORAVETZ ” Practice Location

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