Basic Information
Provider Information
NPI: 1609337963
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WEISER
FirstName: RASHINA
MiddleName: Y.
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3949 S 6TH ST
Address2:  
City: KLAMATH FALLS
State: OR
PostalCode: 976034746
CountryCode: US
TelephoneNumber: 5418821487
FaxNumber: 5418821670
Practice Location
Address1: 635 MAIN ST
Address2:  
City: KLAMATH FALLS
State: OR
PostalCode: 976016007
CountryCode: US
TelephoneNumber: 5418821487
FaxNumber: 5418841841
Other Information
ProviderEnumerationDate: 03/28/2019
LastUpdateDate: 03/28/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400X  Y Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)

No ID Information.


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