Individual
ANDREA TANAKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT INTERN
Contact information
Practice address
374 W 12TH AVE STE 1, EUGENE, OR 97401
(541) 525-0668
Mailing address
374 W 12TH AVE STE 1, EUGENE, OR 97401-3449
(541) 525-0668
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
06/26/2017
Last updated
11/08/2019
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