Vanbeuzekom, Laurel Lee

Vanbeuzekom, Laurel Lee is an individual health care provider with primary practice located at 1299 Nw Ellan St Ste 3 , Roseburg OR 97470-2031. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Allopathic & Osteopathic Physicians / Family Medicine. Behavioral Health & Social Service Providers / Marriage & Family Therapist is her primary health care specialty. Vanbeuzekom, Laurel Lee can be contacted via phone (541) 580-7893.

Contact Information

Primary practice address
1299 Nw Ellan St Ste 3 Roseburg OR 97470-2031
Phone: (541) 580-7893
Fax: (541) 957-0191
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X T0440 Oregon
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X T0440 Oregon

Profile Details

NPI number 1144389354
LBN Legal business name Vanbeuzekom, Laurel Lee
Credentials LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2006
Last updated Jun 23rd, 2016 - about 9 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 1144389354 NPPES
Oregon MEDICAID 165772
Oregon MEDICAID 500688893

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