Cockburn, Wade Horton
Cockburn, Wade Horton is an individual health care provider with primary practice located at 805 Ne Reservoir Ln , Toledo OR 97391-1335. He recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as his primary health care specialty. Cockburn, Wade Horton can be contacted via phone (541) 336-2254.Contact Information
Primary practice address
805 Ne Reservoir Ln
Toledo OR 97391-1335
Phone: (541) 336-2254
Fax: (541) 336-1803
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X | 106 | Oregon |
Profile Details
| NPI number | 1659510238 |
|---|---|
| LBN Legal business name | Cockburn, Wade Horton |
| Credentials | MA, PHD(C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 5th, 2009 |
| Last updated | Feb 5th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659510238 | NPPES |
| Oregon | Other | 93-0698327 | PRIVATE NONPROFIT |
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