Provider Demographics
NPI:1487206033
Name:HUMPHREYS, CHELSEA (LPN, BCN)
Entity Type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:
Last Name:HUMPHREYS
Suffix:
Gender:F
Credentials:LPN, BCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3003 WILLAMETTE ST STE B
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-3295
Mailing Address - Country:US
Mailing Address - Phone:541-972-8184
Mailing Address - Fax:
Practice Address - Street 1:3003 WILLAMETTE ST STE B
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405
Practice Address - Country:US
Practice Address - Phone:541-972-8184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-14
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist
No174H00000XOther Service ProvidersHealth Educator
No246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEG