Provider Demographics
NPI:1700500717
Name:PINK LOTUS HEALING
Entity Type:Organization
Organization Name:PINK LOTUS HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW, CADC L
Authorized Official - Phone:541-953-2632
Mailing Address - Street 1:2526 FRIENDLY ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-2251
Mailing Address - Country:US
Mailing Address - Phone:541-953-2632
Mailing Address - Fax:
Practice Address - Street 1:345 W 13TH AVE RM 2
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3483
Practice Address - Country:US
Practice Address - Phone:541-953-2632
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health