Provider Demographics
NPI:1497988638
Name:MARK ARON, PSYD, MSW, PC
Entity Type:Organization
Organization Name:MARK ARON, PSYD, MSW, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:ARON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, MSW, PC
Authorized Official - Phone:541-754-9072
Mailing Address - Street 1:216 NW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-4812
Mailing Address - Country:US
Mailing Address - Phone:541-754-9072
Mailing Address - Fax:541-754-0477
Practice Address - Street 1:216 NW 6TH ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-4812
Practice Address - Country:US
Practice Address - Phone:541-754-9072
Practice Address - Fax:541-754-0477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1097251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health