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1093180226
ROWDY RANDALL
REDMOND, OR
NPI
1093180226
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR 15-CRM-170)
Enumeration Date
2015-12-14
Last Update Date
2015-12-14
Business Address
-- ROWDY RANDALL CRM
340 NW 5TH ST BOX 1710
REDMOND, OR 97756-1869
Phone number: 541-516-4087
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Mailing Address
-- ROWDY RANDALL CRM
676 NE NEGUS WAY
REDMOND, OR 97756-8527
Phone number: 541-516-4087
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