Organization
BLUE PINE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD STREETER LPC (OWNER)
(541) 647-9609
Entity
Organization
Contact information
Practice address
2214 NE DIVISION ST STE 101, BEND, OR 97703-3551
(541) 647-9609
Mailing address
70 SW CENTURY DR STE 100-162, BEND, OR 97702-3557
(541) 647-9609
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/18/2024
Last updated
09/18/2024
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