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1063143071
BLAINE LORRENCE
REDMOND, OR
NPI
1063143071
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2022-06-21
Last Update Date
2022-06-21
Business Address
BLAINE LORRENCE CADC-R
1655 SW HIGHLAND AVE STE 3
REDMOND, OR 97756-2558
Phone number: 541-923-2654
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Mailing Address
BLAINE LORRENCE CADC-R
423 NW 6TH ST APT 8
REDMOND, OR 97756-1685
Phone number:
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