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780 Commercial St Se Suite 202 & 305 Salem OR 97301-3463 | |
| (503) 577-7753 | |
| (503) 616-3804 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 780 Commercial St Se, Salem, Oregon |
| Authorized Official Name and Position | Joseph Haugen (OPERATIONS MANAGER) |
| Authorized Official Contact | 5038772755 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 21842 Keizer OR 97307-1842 Ph: (503) 577-7753 | 780 Commercial St Se Suite 202 & 305 Salem OR 97301-3463 Ph: (503) 577-7753 |
| NPI Number | 1841986346 |
|---|---|
| Provider Enumeration Date | 04/17/2023 |
| Last Update Date | 12/17/2024 |
| Certification Date | 12/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841986346 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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