Provider Demographics
NPI:1851708994
Name:KHAN, SAIRA (LCPC, CADC, CTTS,NCC)
Entity type:Individual
Prefix:
First Name:SAIRA
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:LCPC, CADC, CTTS,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7515 FALCON CREST DR # 200
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-5014
Mailing Address - Country:US
Mailing Address - Phone:541-904-5216
Mailing Address - Fax:
Practice Address - Street 1:1580 VALLEY RIVER DR STE 290
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2179
Practice Address - Country:US
Practice Address - Phone:541-904-5216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-22
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178007535101YP2500X
IL180012189101YP2500X
ORC10035101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1851708994Medicaid