Basic Information
| Provider Information | |||||||||
| NPI: | 1710694583 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARKHAS | ||||||||
| FirstName: | SODNOMDARJAA | ||||||||
| MiddleName: | |||||||||
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| OtherLastName: | BARKHAS | ||||||||
| OtherFirstName: | SODNOMDARJAA | ||||||||
| OtherMiddleName: | |||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1200 HILYARD ST STE 570 | ||||||||
| Address2: | |||||||||
| City: | EUGENE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974018168 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4582057070 | ||||||||
| FaxNumber: | 4582057089 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 HILYARD ST STE 570 | ||||||||
| Address2: | |||||||||
| City: | EUGENE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974018168 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4582057070 | ||||||||
| FaxNumber: | 4582057089 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2022 | ||||||||
| LastUpdateDate: | 11/01/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.