Provider Demographics
NPI:1871630376
Name:MARGULIS, JANE BETH (MS, MFC)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:BETH
Last Name:MARGULIS
Suffix:
Gender:F
Credentials:MS, MFC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 NORTH BAYVIEW ROAD
Mailing Address - Street 2:
Mailing Address - City:WALDPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97394-9639
Mailing Address - Country:US
Mailing Address - Phone:541-563-4141
Mailing Address - Fax:
Practice Address - Street 1:2015 NW 39TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:LINCOLN CITY
Practice Address - State:OR
Practice Address - Zip Code:97367-4824
Practice Address - Country:US
Practice Address - Phone:541-994-2905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 39386106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist