Provider Demographics
NPI:1225601099
Name:ROBYN LOXLEY WELLNESS
Entity Type:Organization
Organization Name:ROBYN LOXLEY WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:K
Authorized Official - Last Name:LOXLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:503-412-8554
Mailing Address - Street 1:9880 SE AMARILLO RD
Mailing Address - Street 2:
Mailing Address - City:PRINEVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97754-9454
Mailing Address - Country:US
Mailing Address - Phone:503-412-8554
Mailing Address - Fax:
Practice Address - Street 1:190 NW 4TH ST
Practice Address - Street 2:
Practice Address - City:PRINEVILLE
Practice Address - State:OR
Practice Address - Zip Code:97754-1820
Practice Address - Country:US
Practice Address - Phone:541-416-3697
Practice Address - Fax:541-416-3707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health