Individual provider · Type 1 NPI

Mia Phae

Mental Health Counselor · Pendleton, OR

NPI number 1962039602 Active

Practice location

2575 Westgate Bldg 3
Pendleton, OR 97801-9613

Call (541) 276-6330 Map

Fax (541) 276-6295

Mailing address

3587 Heathrow Way
Medford, OR 97504-4004

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1962039602

Mia Phae's National Provider Identifier is 1962039602, issued on Mar 24, 2020. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Pendleton, OR. The record was last updated on Mar 24, 2020.