Provider Demographics
NPI:1073668638
Name:SUNSET, BRIAN R W (MA, CPT)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:R W
Last Name:SUNSET
Suffix:
Gender:M
Credentials:MA, CPT
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 51611
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-0910
Mailing Address - Country:US
Mailing Address - Phone:541-484-2242
Mailing Address - Fax:
Practice Address - Street 1:2255 ARTHUR ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-1522
Practice Address - Country:US
Practice Address - Phone:541-484-2242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYC2005-573101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health