MRS. MARY M ELSETHAGEN (NPI# 1336154012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336154012 |
| Entity Type | Individual |
| Full Name | MRS. MARY M ELSETHAGEN |
| Credential | LPC |
| Practice Address |
101 Nw Boardman Ave. Boardman OR 97818 |
| Mailing Address |
3002 S Edison Pl Kennewick WA 99338-2714 |
| Practice Telephone | 5414812911 |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2009-11-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| Y | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | LPC | C1782 | 01 |
| Street Address |
101 NW BOARDMAN AVE. |
| City | BOARDMAN |
| State | OR |
| Zip Code | 97818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750433322 | Teresa Lopez | Counselor | 101 Nw Boardman Ave., Boardman, OR 97818 | 2007-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477178721 | Kaelyn Rose Lindsay | Counselor | 104 Sw Kinkade Ave., Boardman, OR 97818 | 2020-06-12 |
| 1225674807 | Jose James Ortiz Jr. | Counselor | 104 Kinkade Ave, Boardman, OR 97818 | 2019-11-19 |
| 1982149647 | Kymberli Dawn Erevia | Specialist | 104 S. W. Kinkade Road, Boardman, OR 97818 | 2017-01-04 |
| 1194277814 | Scott R Ruch | Community/Behavioral Health | 104 Sw. Kinkade Rd, Boardman, OR 97818 | 2016-10-28 |
| 1144660168 | Cydney M. Morgan | Counselor | 103 Sw Kinkade Rd., Boardman, OR 97818 | 2013-07-05 |
| 1801151121 | Mayra Colin Carrillo | Counselor | 104 S.w. Kinkade Rd., Boardman, OR 97818 | 2012-07-12 |
| 1306103429 | Good Shepherd Medical Service Corp | Pharmacy | 220 S. Main, Boardman, OR 97818 | 2012-04-13 |
| 1437359387 | Emily Dawn Reynolds | Counselor | 104 Sw Kinkade Road, Boardman, OR 97818 | 2007-07-19 |
| 1548485865 | Hayden Family Dentistry Group | Dentist | 300 Tatone, Boardman, OR 97818 | 2007-04-13 |
| 1336294057 | Brandi Nichole Pollick | Counselor | 101 Nw Boardman Ave, Boardman, OR 97818 | 2007-01-24 |
| Find all providers in zip 97818 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972064939 | Ciccone Counseling LLC | Counselor | 850 Boardman Canfield Rd Ste 1, Boardman, OH 44512-4234 | 2019-03-30 |
| 1871954693 | Jennifer Mackovick | Counselor | 64 Spring Garden Ct, Boardman, OH 44512-6526 | 2016-03-08 |
| 1205235751 | Denise James | Counselor | 950 Windham Ct Ste 4, Boardman, OH 44512-5083 | 2014-08-21 |
| 1578657490 | Treat Yourself Center for Holistic Health | Counselor | 837 Boardman Canfield Rd, Suite 206, Boardman, OH 44512-4380 | 2006-10-03 |
| 1285727800 | Marilyn T Burns | Counselor | 725 Boardman Canfield Rd Bldg K, Suite 5, Boardman, OH 44512-4380 | 2006-10-02 |
| 1528058948 | Richard A Hammond | Counselor | 940 Windham Ct, Suite 6, Boardman, OH 44512-5060 | 2005-10-26 |
| 1629677166 | Gloris A Griffin Counseling Services, LLC | Counselor | 5500 Market St Ste 106, Boardman, OH 44512-2616 | 2020-10-24 |
| 1487251419 | Kathrine A Vance-righetti | Counselor | 997 Boardman Canfield Rd, Boardman, OH 44512-4223 | 2020-10-02 |
| 1093221061 | Courtney Todd Mazey | Counselor | 8261 Market St, Boardman, OH 44512-6254 | 2017-12-28 |
| 1548775588 | Cheyenne Taylor Bohrer | Counselor | 8261 Market St, Boardman, OH 44512-6254 | 2017-12-13 |
| Find all providers in BOARDMAN | ||||
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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.