Individual
MARK J SIEMENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1200 HILYARD ST, EUGENE, OR 97401-8122
(541) 744-0828
(541) 687-6214
Mailing address
PO BOX 24410, EUGENE, OR 97402-0451
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
002051
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
079207
—
OR
Enumeration date
06/17/2006
Last updated
07/02/2012
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