Elsethagen, Mary M

Elsethagen, Mary M is an individual health care provider with primary practice located at 101 Nw Boardman Ave. , Boardman OR 97818. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Elsethagen, Mary M can be contacted via phone (541) 481-2911.

Contact Information

Primary practice address
101 Nw Boardman Ave. Boardman OR 97818
Phone: (541) 481-2911
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Professional 101YP2500X

Profile Details

NPI number 1336154012
LBN Legal business name Elsethagen, Mary M
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 30th, 2006
Last updated Nov 4th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336154012 NPPES
Oregon Other C1782 LPC

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