Provider Demographics
NPI:1760217491
Name:TOJA, LAVONDA RENEE
Entity type:Individual
Prefix:
First Name:LAVONDA
Middle Name:RENEE
Last Name:TOJA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAVONDA
Other - Middle Name:RENEE
Other - Last Name:TOJA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5441 S. MAC ADAM STREEET
Mailing Address - Street 2:SUITE R
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239
Mailing Address - Country:US
Mailing Address - Phone:541-778-3993
Mailing Address - Fax:541-858-8167
Practice Address - Street 1:503 AIRPORT RD STE 101
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-4159
Practice Address - Country:US
Practice Address - Phone:541-200-2900
Practice Address - Fax:541-200-2948
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR10956101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health