Individual
MR. JACOB BANNON SPAVINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
687 CHESHIRE AVE, EUGENE, OR 97402-5060
(541) 914-8499
Mailing address
687 CHESHIRE AVE, EUGENE, OR 97402
(541) 914-8499
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
1041S0200X
School Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
01/03/2012
Last updated
02/15/2018
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