Provider Demographics
NPI:1083034904
Name:OSWALD, LAURA KATHERINE (LPC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:KATHERINE
Last Name:OSWALD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 CHAD DR STE 350
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408-7602
Mailing Address - Country:US
Mailing Address - Phone:541-687-6983
Mailing Address - Fax:541-684-7638
Practice Address - Street 1:12901 SE 97TH AVE
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-7901
Practice Address - Country:US
Practice Address - Phone:503-545-7970
Practice Address - Fax:503-655-6806
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-17
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC6530101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health