1760469324 NPI number — RON UNGER L.C.S.W.

Table of content: RON UNGER L.C.S.W. (NPI 1760469324)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760469324 NPI number — RON UNGER L.C.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
UNGER
Provider First Name:
RON
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
L.C.S.W.
Provider Gender Code:
M

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:
1760469324
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/30/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1770 AUGUSTA ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EUGENE
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97403-2209
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-513-1811
Provider Business Mailing Address Fax Number:
541-686-2440

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
492 E 13TH AVE STE 107
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EUGENE
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97401-4250
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-513-1811
Provider Business Practice Location Address Fax Number:
844-729-1748
Provider Enumeration Date:
12/26/2005

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: 1041C0700X , with the licence number:  L3345 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2003850-01 . This is a "REGENCE PROVIDER NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: J0147 . This is a "PACIFIC SOURCE ID NUMBER" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com