Provider Demographics
NPI:1689823544
Name:VEATCH, MAUREEN ANN (MA, LPC)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:ANN
Last Name:VEATCH
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16855 SE BERGHAMMER ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97267-4951
Mailing Address - Country:US
Mailing Address - Phone:503-786-3866
Mailing Address - Fax:503-659-0099
Practice Address - Street 1:11630 SE 40TH AVE
Practice Address - Street 2:SUITE A
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-6195
Practice Address - Country:US
Practice Address - Phone:503-786-3866
Practice Address - Fax:503-659-0099
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2221101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional