Provider Demographics
NPI:1396596326
Name:WOLDEIT, CAILA
Entity type:Individual
Prefix:
First Name:CAILA
Middle Name:
Last Name:WOLDEIT
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 1:1010 11TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-2019
Mailing Address - Country:US
Mailing Address - Phone:541-829-1199
Mailing Address - Fax:
Practice Address - Street 1:1010 11TH AVE SW
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-2019
Practice Address - Country:US
Practice Address - Phone:541-829-1199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health