IndividualActive
Amy Douglas
NPI 1104785401 · Mental Health Clinic/Center (Including Community Mental Health Center) · Medford, OR
Provider details
- NPI number
- 1104785401
- Entity type
- Individual
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)Ambulatory Health Care Facilities
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
1175 E Main St
Medford, OR 97504-7499
Phone: (458) 488-1250
Fax: (458) 488-1252
Approximate (ZIP-level) locationGet directions
Mailing address
180 Manzanita Dr
Shady Cove, OR 97539-0150
Additional practice locations (1)
- 3120 Centurion CirMedford, OR 97504-8363Phone: (458) 488-1250Fax: (458) 488-1252
Registry dates
- Enumerated
- 2026-01-21
- Last updated
- 2026-02-19
- Certified
- 2026-02-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.