Provider Demographics
NPI:1659009306
Name:JUTZI, WILLA
Entity type:Individual
Prefix:
First Name:WILLA
Middle Name:
Last Name:JUTZI
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 1:1551 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4010
Mailing Address - Country:US
Mailing Address - Phone:541-517-9733
Mailing Address - Fax:888-971-3877
Practice Address - Street 1:1500 NE IRVING ST STE 440
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-4208
Practice Address - Country:US
Practice Address - Phone:541-517-9733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC9732101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health