Provider Demographics
NPI:1689701492
Name:DRAEGER, JAMES ROLLIN (LPC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ROLLIN
Last Name:DRAEGER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 VILLA RD
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-1855
Mailing Address - Country:US
Mailing Address - Phone:971-275-3787
Mailing Address - Fax:503-491-0462
Practice Address - Street 1:430 VILLA RD
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-1855
Practice Address - Country:US
Practice Address - Phone:971-275-3787
Practice Address - Fax:503-491-0462
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORCO 998101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health