| Doctor Name: | DR. NAOMI ANN MANDSAGER |
| NPI Number: | 1043464423 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC, PH. D. |
| License Number: | C1500 |
| Business Practice Address: | 1450 Ne Village St Fairview, OR - 970243827 |
| Business Phone Number: | 5034924492 |
| Business Fax Number: | |
| Mailing Address: | 1450 Ne Village St, FAIRVIEW |
| State: | OR |
| Postal Code: | 970243827 |
| Phone Number: | 5034924492 |
| Fax Number: | |
| NPI Enumeration Date: | 11/11/2008 |
| NPI Last Update Date: | 11/11/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | C1500 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |