1972489813 NPI number — YOUR OWN PATH COUNSELING

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972489813 NPI number — YOUR OWN PATH COUNSELING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YOUR OWN PATH COUNSELING
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972489813
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/14/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7325 NE IMBRIE DR , PMB 192
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HILLSBORO
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97124
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2155 GABLE RD UNIT B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT HELENS
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97051-3140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-308-1462
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/14/2025

Additional Information

Authorized Official

Authorized Official Last Name:
LANEY
Authorized Official First Name:
ABIGAIL
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
540-683-5912

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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