Individual
ERIC TENGREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
29413 RUSSELL ST, GOLD BEACH, OR 97444
(541) 247-6566
(541) 247-6549
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(480) 432-5551
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
NM
Other
Enumeration date
09/27/2016
Last updated
08/10/2018
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