Individual
PATRICK L FAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1234 PEARL ST, SUITE 3, EUGENE, OR 97401-3642
(541) 968-7424
Mailing address
980 BOBOLINK AVE, EUGENE, OR 97404-1513
(541) 607-2728
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/17/2007
Last updated
06/09/2016
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