Provider Demographics
NPI:1386094928
Name:MOYNIHAN, WENDIE S (QMHA)
Entity type:Individual
Prefix:
First Name:WENDIE
Middle Name:S
Last Name:MOYNIHAN
Suffix:
Gender:F
Credentials:QMHA
Other - Prefix:MS
Other - First Name:WENDIE
Other - Middle Name:S
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:QMHA
Mailing Address - Street 1:360 E 10TH AVE STE 450
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3273
Mailing Address - Country:US
Mailing Address - Phone:541-687-6983
Mailing Address - Fax:541-687-2063
Practice Address - Street 1:360 E 10TH AVE STE 450
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3273
Practice Address - Country:US
Practice Address - Phone:541-687-6983
Practice Address - Fax:541-687-2063
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health