Basic Information
| Provider Information | |||||||||
| NPI: | 1467793489 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HATCH | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | WILLIAM | ||||||||
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| Credential: | MS | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | HATCH | ||||||||
| OtherFirstName: | BILLY | ||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1305 HAMMOCK ST | ||||||||
| Address2: | |||||||||
| City: | EUGENE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974012059 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5415567090 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2517 MARTIN LUTHER KING JR BLVD | ||||||||
| Address2: | |||||||||
| City: | EUGENE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974015898 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5413424293 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2013 | ||||||||
| LastUpdateDate: | 09/13/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101Y00000X | N | Behavioral Health & Social Service Providers | Counselor | 172V00000X | N | Other Service Providers | Community Health Worker |
No ID Information.