Individual
JORDAN TANGAVELOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1551 PEARL ST, EUGENE, OR 97401-4010
(541) 517-9733
Mailing address
1551 PEARL ST, EUGENE, OR 97401-4010
(541) 517-9733
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T3121
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500687160
—
OR
Enumeration date
04/25/2015
Last updated
11/14/2025
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