Provider Demographics
NPI:1578302857
Name:BIEHL, TESSA ELENA SABINA (THW)
Entity type:Individual
Prefix:
First Name:TESSA
Middle Name:ELENA SABINA
Last Name:BIEHL
Suffix:
Gender:F
Credentials:THW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3544 GEORGE CT
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-5325
Mailing Address - Country:US
Mailing Address - Phone:541-799-5389
Mailing Address - Fax:
Practice Address - Street 1:890 BELTLINE RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-1091
Practice Address - Country:US
Practice Address - Phone:541-515-6556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-24
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR111108172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker