Provider Demographics
NPI:1578149928
Name:WEST COAST WELLNESS CENTER FOR HEALTH, INC.
Entity Type:Organization
Organization Name:WEST COAST WELLNESS CENTER FOR HEALTH, INC.
Other - Org Name:LEFT COAST WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CAZAVILAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:541-632-4014
Mailing Address - Street 1:1355 OAK ST STE 100
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3566
Mailing Address - Country:US
Mailing Address - Phone:541-632-4014
Mailing Address - Fax:855-433-4124
Practice Address - Street 1:1355 OAK ST STE 100
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3566
Practice Address - Country:US
Practice Address - Phone:541-632-4014
Practice Address - Fax:855-433-4124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-23
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty