Organization
GUIDING LIGHTHOUSE THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATTY KOKER LCSW (MENTAL HEALTH THERAPIST)
(541) 286-5031
Entity
Organization
Contact information
Practice address
2306 NW KINGS BLVD, CORVALLIS, OR 97330-3925
(541) 286-5031
Mailing address
2042 SW KENDRA ST, CORVALLIS, OR 97333-2266
(541) 286-5031
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053887109
—
OR
Enumeration date
07/18/2024
Last updated
07/18/2024
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