Provider Demographics
NPI:1508013269
Name:COHEN, SETH (MHRT)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:
Last Name:COHEN
Suffix:
Gender:M
Credentials:MHRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 WILLAMETTE ST STE 412
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2688
Mailing Address - Country:US
Mailing Address - Phone:971-600-1375
Mailing Address - Fax:
Practice Address - Street 1:13541 SE MARKET ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97233-1752
Practice Address - Country:US
Practice Address - Phone:503-258-9734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-25
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No372600000XNursing Service Related ProvidersAdult Companion