1558469700 NPI number — MS. JANELLE R THAYER-ENGLE M.A., L.P.C.

Table of content: MS. JANELLE R THAYER-ENGLE M.A., L.P.C. (NPI 1558469700)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558469700 NPI number — MS. JANELLE R THAYER-ENGLE M.A., L.P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
THAYER-ENGLE
Provider First Name:
JANELLE
Provider Middle Name:
R
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.A., L.P.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
THAYER
Provider Other First Name:
JANELLE
Provider Other Middle Name:
R
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
L.M.P.C.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1558469700
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/25/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
JANELLE ENGLE MA LPC .
Provider Second Line Business Mailing Address:
2740 CRATER LANE
Provider Business Mailing Address City Name:
NEWBERG
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97132-1038
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-899-7025
Provider Business Mailing Address Fax Number:
503-961-9300

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
JANELLE ENGLE MA LPC .
Provider Second Line Business Practice Location Address:
2740 CRATER LANE
Provider Business Practice Location Address City Name:
NEWBERG
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97132-1038
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-899-7025
Provider Business Practice Location Address Fax Number:
503-961-9300
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  LH00006451 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 137159 . This is a "MANAGED HEALTH NETWORK" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 38-3812830 . This is a "TAX ID" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: C3557 . This is a "STATE LICENSE" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".




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