Individual
TERAH VAN DUSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
590 TYLER ST, #3, EUGENE, OR 97402-4552
(323) 829-1748
Mailing address
PO BOX 461, NOTI, OR 97461-0461
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/28/2013
Last updated
08/28/2013
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