Organization
WESTERN CLINICAL & FORENSIC SERVICES
Active
Organization
WESTERN CLINICAL & FORENSIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MINDI WEBER (CREDENTIALING / CONTRACT MANAGER)
(801) 562-4484
Entity
Organization
Contact information
Practice address
1400 EXECUTIVE PKWY STE 260, EUGENE, OR 97401-7121
(541) 802-6597
Mailing address
1400 EXECUTIVE PKWY STE 260, EUGENE, OR 97401-7121
(541) 802-6597
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902095334
INDIVIDUAL NPI
—
Enumeration date
12/06/2018
Last updated
12/06/2018
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