Provider Demographics
NPI:1992720007
Name:GREGOR, MARION ELIZABETH (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:MARION
Middle Name:ELIZABETH
Last Name:GREGOR
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 WATER AVE NW
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-2298
Mailing Address - Country:US
Mailing Address - Phone:541-812-1242
Mailing Address - Fax:541-928-1678
Practice Address - Street 1:213 WATER AVE NW
Practice Address - Street 2:SUITE 400
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-2298
Practice Address - Country:US
Practice Address - Phone:541-812-1242
Practice Address - Fax:541-928-1678
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR24071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR117227Medicare ID - Type UnspecifiedMEDICARE PART B