Corwin, Mae Lynn

Corwin, Mae Lynn is an individual health care provider with primary practice located at 3425 13Th St , Baker City OR 97814-1340. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Peer Specialist, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Other Service Providers / Peer Specialist is her primary health care specialty. Corwin, Mae Lynn can be contacted via phone (541) 523-7400.

Contact Information

Primary practice address
3425 13Th St Baker City OR 97814-1340
Phone: (541) 523-7400
Fax: (541) 523-4927
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X T-20-168 Oregon

Profile Details

NPI number 1265051726
LBN Legal business name Corwin, Mae Lynn
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 14th, 2020
Last updated Dec 8th, 2020 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265051726 NPPES
Oregon Other T-20-168 CADC-R CERTIFICATE
Oregon MEDICAID 500781022 CADC-R CERTIFICATE

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