Gonzales, Michael

Gonzales, Michael is an individual health care provider with primary practice located at 3995 Marcola Rd , Springfield OR 97477-7948. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Gonzales, Michael can be contacted via phone (541) 726-1465.

Contact Information

Primary practice address
3995 Marcola Rd Springfield OR 97477-7948
Phone: (541) 726-1465
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X Oregon
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1437524642
LBN Legal business name Gonzales, Michael
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 14th, 2015
Last updated Mar 14th, 2019 - about 7 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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Identifiers

StateTypeNumberIssuer
All States NPI 1437524642 NPPES
Oregon MEDICAID 500679-999

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