MR. DAVID IRVING WADSWORTH (NPI# 1992200810) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1992200810 |
Entity Type | Individual |
Full Name | MR. DAVID IRVING WADSWORTH |
Credential | CADC 1 |
Practice Address |
1 Serenity Ln Coburg OR 97408-9350 |
Mailing Address |
2074 Bonnie Ln Springfield OR 97477-6507 |
Practice Telephone | 5412845670 |
Mailing Telephone | 5413598781 |
Enumeration Date | 2018-03-25 |
Last Update Date | 2018-03-25 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
18-03-06 | OR | Behavioral Health & Social Service Providers |
Street Address |
1 SERENITY LN |
City | COBURG |
State | OR |
Zip Code | 97408-9350 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952696981 | Wendi Lou Roberts | Counselor | 1 Serenity Ln, Coburg, OR 97408-9350 | 2011-06-17 |
1497393748 | Lorri Rai Roberts | Counselor | 1 Serenity Ln, Coburg, OR 97408-9350 | 2019-12-17 |
1669027314 | Pamela Ann Joyner | Counselor | 1 Serenity Ln, Coburg, OR 97408-9350 | 2019-08-08 |
1194379701 | Loraine Christina Lengyel | Counselor | 1 Serenity Ln, Coburg, OR 97408-9350 | 2019-07-31 |
1164076162 | Kristine Teresa Miller | Counselor | 1 Serenity Ln, Coburg, OR 97408-9350 | 2019-07-29 |
1902378961 | Kimberley Slater | Counselor | 1 Serenity Ln, Coburg, OR 97408-9350 | 2018-12-31 |
1346747045 | Samantha Galluzzo | Counselor | 1 Serenity Ln, Coburg, OR 97408-9350 | 2018-04-09 |
1710483722 | Emily Elise Gibson | Counselor | 1 Serenity Ln, Coburg, OR 97408-9350 | 2018-03-30 |
1689123762 | Roseanna Fern Boyer | Counselor | 1 Serenity Ln, Coburg, OR 97408-9350 | 2016-09-29 |
1407216401 | Stephanie Ann Jones | Counselor | 1 Serenity Ln, Coburg, OR 97408-9350 | 2016-03-03 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619575008 | Janna Marie Check | Physician Assistant | 3555 Chad Drive, Eugene, OR 97408 | 2020-10-16 |
1376181982 | Quentin Rowan | Counselor | 91150 Industrial Way, Coburg, OR 97408 | 2019-12-13 |
1659918621 | Nicholas Andrew Sparks | Counselor | 91150coburg Industrial Way, Coburg, OR 97408 | 2019-12-09 |
1629619267 | Suzan Marie Farr | Counselor | 91150 Coburg Industrial Lane, Coburg, OR 97408 | 2019-10-04 |
1629538608 | Shawn Michael Feddersen | Hearing Instrument Specialist | 1020 Green Acres Rd #8, Eugene, OR 97408 | 2019-03-25 |
1427513241 | Margaret Elizabeth Desroches | Registered Nurse | Delta Oaks Community Health Center, 1022 Green Acres Rd., Eugene, OR 97408 | 2019-02-06 |
1295218527 | Stephen Duane Sawyer | Counselor | 91150 N Coburg Industrial Way, Coburg, OR 97408 | 2018-09-12 |
1003339466 | Carly M. Peterschmidt, Dmd, LLC | Clinic/Center | 622 E 22nd Avenue, Suite A, Eugene, OR 97408 | 2017-07-18 |
1821549536 | Eugene Urgent Care | Clinic/Center | 1800 Coburg Rd., Eugene, OR 97408 | 2016-10-18 |
1851752232 | Nicole Marie Westbrook | Chiropractor | 90971 S Willamette St, Coburg, OR 97408 | 2016-03-14 |
Find all providers in zip 97408 |
Taxonomy Code | 101YA0400X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Addiction (Substance Use Disorder) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376181982 | Quentin Rowan | Counselor | 91150 Industrial Way, Coburg, OR 97408 | 2019-12-13 |
1659918621 | Nicholas Andrew Sparks | Counselor | 91150coburg Industrial Way, Coburg, OR 97408 | 2019-12-09 |
1295218527 | Stephen Duane Sawyer | Counselor | 91150 N Coburg Industrial Way, Coburg, OR 97408 | 2018-09-12 |
1902266125 | Layne R. Frambes | Counselor | 91320 N Industrial Way, Coburg, OR 97408-9492 | 2016-03-01 |
1952696981 | Wendi Lou Roberts | Counselor | 1 Serenity Ln, Coburg, OR 97408-9350 | 2011-06-17 |
1609416460 | Kelsey Leigh Zimmerman | Counselor | 91150 Coburg Industrial Way, Coburg, OR 97408 | 2020-01-09 |
1497393748 | Lorri Rai Roberts | Counselor | 1 Serenity Ln, Coburg, OR 97408-9350 | 2019-12-17 |
1639716525 | Brandy Lynn Blackwell | Counselor | 91150 N Coburg Industrial Way, Coburg, OR 97408-1313 | 2019-12-10 |
1851938880 | Scott Laurence Carpenter | Counselor | 91150 Coburg Industrial Way, Coburg, OR 97408 | 2019-12-10 |
1669027314 | Pamela Ann Joyner | Counselor | 1 Serenity Ln, Coburg, OR 97408-9350 | 2019-08-08 |
Find all providers in COBURG |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.