Provider Demographics
NPI:1487037271
Name:MUSCATO, NOREEN LYNN
Entity Type:Individual
Prefix:
First Name:NOREEN
Middle Name:LYNN
Last Name:MUSCATO
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 1:1713 PENN LN STE B
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-1592
Mailing Address - Country:US
Mailing Address - Phone:503-258-4545
Mailing Address - Fax:
Practice Address - Street 1:1713 PENN LN STE B
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-1592
Practice Address - Country:US
Practice Address - Phone:503-258-4545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-30
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF73259101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health