Provider Demographics
NPI:1811138670
Name:GLASSER, LISA M (LAC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:GLASSER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1274 W 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-4523
Mailing Address - Country:US
Mailing Address - Phone:541-505-4000
Mailing Address - Fax:
Practice Address - Street 1:1274 W 7TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-4523
Practice Address - Country:US
Practice Address - Phone:541-505-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-09
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR101YM0800X
ORAC01270171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty