Provider Demographics
NPI:1033142062
Name:MALSCH, MARGARET A (MSW)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:A
Last Name:MALSCH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 24410
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-0451
Mailing Address - Country:US
Mailing Address - Phone:541-902-6140
Mailing Address - Fax:541-902-7533
Practice Address - Street 1:1525 12TH ST STE 22
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:OR
Practice Address - Zip Code:97439-8487
Practice Address - Country:US
Practice Address - Phone:541-902-0408
Practice Address - Fax:541-902-7533
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL2281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORL0228OtherSTATE LICENSE
OR276368Medicaid
ORR100394Medicare PIN
OR276368Medicaid