Individual
FREDERICK M DYGERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1711 WILLAMETTE ST STE 2, EUGENE, OR 97401-4014
(541) 520-1679
Mailing address
242 CANARY AVE, CRESWELL, OR 97426-9879
(541) 520-1679
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
97-04-19
OR
104100000X
Social Worker
A2316
OR
1041C0700X
Clinical Social Worker
Primary
L5227
OR
Other
Enumeration date
11/08/2010
Last updated
05/30/2025
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