Provider Demographics
NPI:1558673780
Name:NYONE, DARCY GWEN (MA)
Entity type:Individual
Prefix:MRS
First Name:DARCY
Middle Name:GWEN
Last Name:NYONE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 SE LAKE RD STE 325
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-2185
Mailing Address - Country:US
Mailing Address - Phone:503-786-1711
Mailing Address - Fax:503-786-9919
Practice Address - Street 1:6400 SE LAKE RD STE 325
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-2185
Practice Address - Country:US
Practice Address - Phone:503-786-1711
Practice Address - Fax:503-786-9919
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3085101YP2500X, 101YP2500X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR164936Medicaid