Provider Demographics
NPI:1063902153
Name:PIPPERT, ANNE LOUISE
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:LOUISE
Last Name:PIPPERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 NE LILAC CT
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-5092
Mailing Address - Country:US
Mailing Address - Phone:503-936-3514
Mailing Address - Fax:
Practice Address - Street 1:60060 LAKE SHORE RD
Practice Address - Street 2:
Practice Address - City:JOSEPH
Practice Address - State:OR
Practice Address - Zip Code:97846-8468
Practice Address - Country:US
Practice Address - Phone:503-936-3514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-14
Last Update Date:2023-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty