Provider Demographics
NPI:1124658315
Name:PAKALNISKIS, DAINA (MA)
Entity type:Individual
Prefix:
First Name:DAINA
Middle Name:
Last Name:PAKALNISKIS
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 1:1075 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4606
Mailing Address - Country:US
Mailing Address - Phone:541-321-2278
Mailing Address - Fax:541-246-8826
Practice Address - Street 1:1075 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4606
Practice Address - Country:US
Practice Address - Phone:541-321-2278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-16
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
OR1447715834101YM0800X
ORC8273101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500795385Medicaid
IL1124658315Medicaid