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Individual

MRS. CHIHARU TACHI MALONE IX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
4455 NE HIGHWAY 20, CORVALLIS, OR 97330
(541) 758-5900
Mailing address
4455 NE HIGHWAY 20, CORVALLIS, OR 97330
(541) 758-5900

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C4263
OR
104100000X
Social Worker

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500665675
OR
Enumeration date
06/02/2007
Last updated
11/04/2016
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