Didericksen, Robert

Didericksen, Robert is an individual health care provider with primary practice located at 1501 Pearl St , Eugene OR 97401-4010. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as his primary health care specialty. Didericksen, Robert can be contacted via phone (541) 342-8437.

Contact Information

Primary practice address
1501 Pearl St Eugene OR 97401-4010
Phone: (541) 342-8437
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 0995173 Colorado

Profile Details

NPI number 1407231244
LBN Legal business name Didericksen, Robert
Credentials PMHNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 22nd, 2015
Last updated Nov 4th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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