Provider Demographics
NPI:1568878940
Name:RETTON, MICHELLE LEE
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LEE
Last Name:RETTON
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 1:541 WILLAMETTE ST STE 315
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2692
Mailing Address - Country:US
Mailing Address - Phone:541-824-4461
Mailing Address - Fax:503-400-7452
Practice Address - Street 1:541 WILLAMETTE ST STE 315
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2692
Practice Address - Country:US
Practice Address - Phone:541-824-4461
Practice Address - Fax:503-400-7452
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-07
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL76741041C0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical