Organization
IGNITE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASMINE ROSE PENTER MSW, LCSW (OWNER/CLINICIAN)
(541) 870-2904
Entity
Organization
Contact information
Practice address
438 CHARNELTON ST STE 102, EUGENE, OR 97401-2760
(541) 870-2904
Mailing address
1175 LODGEPOLE CT, SPRINGFIELD, OR 97477-7635
(541) 870-2904
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
05/30/2019
Last updated
03/04/2020
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