Provider Demographics
NPI:1578263232
Name:ALBIN, GARRETT W (REGISTERED ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:GARRETT
Middle Name:W
Last Name:ALBIN
Suffix:
Gender:M
Credentials:REGISTERED ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 COUNTRY CLUB RD STE 222
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2238
Mailing Address - Country:US
Mailing Address - Phone:541-686-6000
Mailing Address - Fax:
Practice Address - Street 1:921 COUNTRY CLUB RD STE 222
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2238
Practice Address - Country:US
Practice Address - Phone:541-868-4294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-09
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
ORR8218101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional