Provider Demographics
NPI:1457499816
Name:VIENE, DENNIS J (PHD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:J
Last Name:VIENE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 E 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4005
Mailing Address - Country:US
Mailing Address - Phone:541-790-0092
Mailing Address - Fax:541-485-5702
Practice Address - Street 1:71 E 15TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4005
Practice Address - Country:US
Practice Address - Phone:541-790-0092
Practice Address - Fax:541-485-5702
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2362103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical