Provider Demographics
NPI:1487057832
Name:HAUGEN, IRIS (LPC)
Entity type:Individual
Prefix:
First Name:IRIS
Middle Name:
Last Name:HAUGEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21842
Mailing Address - Street 2:
Mailing Address - City:KEIZER
Mailing Address - State:OR
Mailing Address - Zip Code:97307-1842
Mailing Address - Country:US
Mailing Address - Phone:503-577-7753
Mailing Address - Fax:503-616-3804
Practice Address - Street 1:780 COMMERCIAL ST SE
Practice Address - Street 2:SUITE 202 & 305
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301
Practice Address - Country:US
Practice Address - Phone:503-573-8053
Practice Address - Fax:503-616-3804
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-30
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC5145101YP2500X, 101YM0800X, 101YM0800X
ORR4180101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional