Provider Demographics
NPI:1972246502
Name:TRANSFORMATIVE HEALTH AND WELLNESS
Entity type:Organization
Organization Name:TRANSFORMATIVE HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:LENEE BLUHM
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:541-227-6331
Mailing Address - Street 1:1300 NW HARRISON BLVD
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-6277
Mailing Address - Country:US
Mailing Address - Phone:541-227-6331
Mailing Address - Fax:
Practice Address - Street 1:1300 NW HARRISON BLVD
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-6277
Practice Address - Country:US
Practice Address - Phone:541-227-6331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-20
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)