Individual
DEIDRE LYNN HATHAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
#171M00000X - CASE M
Contact information
Practice address
2411 MLK JR BLVD, EUGENE, OR 97401
(541) 682-3550
(541) 682-9861
Mailing address
2411 MLK JR BLVD, EUGENE, OR 97401-5824
(541) 682-3550
(541) 682-9861
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OR
175T00000X
Peer Specialist
—
—
Other
Enumeration date
08/02/2017
Last updated
07/21/2022
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