Individual
DR. STEPHEN PETHICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
401 E 10TH AVE, SUITE 530, EUGENE, OR 97401-3367
(541) 687-7787
(855) 646-7433
Mailing address
PO BOX 3163, EUGENE, OR 97403-0163
(541) 687-7787
(855) 646-7433
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1569
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
298598
OMAP
OR
Enumeration date
12/19/2006
Last updated
03/05/2026
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