Provider Demographics
NPI:1154781763
Name:RILEY, JANEY-RAE (MS)
Entity type:Individual
Prefix:
First Name:JANEY-RAE
Middle Name:
Last Name:RILEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 SE 9TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:LINCOLN CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97367-2618
Mailing Address - Country:US
Mailing Address - Phone:541-612-0192
Mailing Address - Fax:
Practice Address - Street 1:1330 SE 9TH ST STE 1
Practice Address - Street 2:
Practice Address - City:LINCOLN CITY
Practice Address - State:OR
Practice Address - Zip Code:97367-2618
Practice Address - Country:US
Practice Address - Phone:541-612-0192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-25
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health