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Individual

DYLAN CHRISTIAN PENCAKOWSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2222 COBURG RD STE 103, EUGENE, OR 97401-4966
(458) 210-2984
(458) 210-2985
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(541) 858-8170
(541) 858-8167

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
01/11/2022
Last updated
01/11/2022
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