Provider Demographics
NPI:1447608153
Name:MEHRENS, NATALIE ROSE
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:ROSE
Last Name:MEHRENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1569 SW NANCY WAY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3234
Mailing Address - Country:US
Mailing Address - Phone:541-617-0377
Mailing Address - Fax:
Practice Address - Street 1:1569 SW NANCY WAY
Practice Address - Street 2:SUITE 1
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3234
Practice Address - Country:US
Practice Address - Phone:541-617-0377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-03
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health