Provider Demographics
NPI:1528418431
Name:IVERSON, PAIGE MARGARETE
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:MARGARETE
Last Name:IVERSON
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 1:1391 W 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-3955
Mailing Address - Country:US
Mailing Address - Phone:503-313-6960
Mailing Address - Fax:
Practice Address - Street 1:1391 W 13TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-3955
Practice Address - Country:US
Practice Address - Phone:503-313-6960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor