Provider Demographics
NPI:1134495807
Name:OBERWEISER, MOLLY (M ED)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:OBERWEISER
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 N. FIRST AVE.
Mailing Address - Street 2:MS #70
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-3072
Mailing Address - Country:US
Mailing Address - Phone:503-846-3120
Mailing Address - Fax:503-846-4560
Practice Address - Street 1:155 N. FIRST AVE.
Practice Address - Street 2:MS #70
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-3072
Practice Address - Country:US
Practice Address - Phone:503-846-3120
Practice Address - Fax:503-846-4560
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional