Organization
ASPEN PSYCHIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN T CHACKO PMHNP (NURSE PRACTITIONER)
(480) 719-0098
Entity
Organization
Contact information
Practice address
1675 W 11TH AVE STE C, EUGENE, OR 97402-3711
(480) 608-0291
(480) 608-0292
Mailing address
1675 W 11TH AVE STE C, EUGENE, OR 97402-3711
(480) 608-0291
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/05/2025
Last updated
02/05/2025
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