Basic Information
Provider Information
NPI: 1003146820
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JAMES
FirstName: NORMA
MiddleName: JEAN
NamePrefix: MS.
NameSuffix:  
Credential: MSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 81997 LOST CREEK RD
Address2:  
City: DEXTER
State: OR
PostalCode: 974319788
CountryCode: US
TelephoneNumber: 5417011554
FaxNumber:  
Practice Location
Address1: 1790 W 11TH AVE
Address2: SUITE 290
City: EUGENE
State: OR
PostalCode: 974023758
CountryCode: US
TelephoneNumber: 5416861262
FaxNumber: 5416860359
Other Information
ProviderEnumerationDate: 12/29/2009
LastUpdateDate: 12/29/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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