Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 3185 | OR |
Y | 103T00000X | Psychologist | 3185 | OR |
N | 103TC1900X | Counseling Psychologist | 3185 | OR |
NPI | 1093389926 |
---|---|
Provider Name | Dr. Christopher Michaels |
First Address | Eugene, OR 97401-3127 |
Second Address | Eugene, OR 97401-3127 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2021 |
Last Update Date | 30/09/2021 |