Provider Demographics
NPI:1922134451
Name:CZUCHNA, BRUCE ERIC (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:ERIC
Last Name:CZUCHNA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DIRECTION
Mailing Address - Street 2:66 CLUB ROAD SUITE 120
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401
Mailing Address - Country:US
Mailing Address - Phone:541-345-2800
Mailing Address - Fax:541-345-4419
Practice Address - Street 1:DIRECTION
Practice Address - Street 2:66 CLUB ROAD SUITE 120
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401
Practice Address - Country:US
Practice Address - Phone:541-345-2800
Practice Address - Fax:541-345-4419
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1645103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist