Provider Demographics
NPI:1538341219
Name:SEITZ, BRITNEY R (MS, CASOT)
Entity type:Individual
Prefix:
First Name:BRITNEY
Middle Name:R
Last Name:SEITZ
Suffix:
Gender:F
Credentials:MS, CASOT
Other - Prefix:
Other - First Name:BRITNEY
Other - Middle Name:R
Other - Last Name:KLASCIUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:996 N REDWOOD ST
Mailing Address - Street 2:
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-2402
Mailing Address - Country:US
Mailing Address - Phone:503-568-9773
Mailing Address - Fax:
Practice Address - Street 1:2905 RIVER RD S
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-9754
Practice Address - Country:US
Practice Address - Phone:503-391-7175
Practice Address - Fax:503-585-3303
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
ORSTBA10140892101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator