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1619757879
SHANNON RUTH MARTINEZ
BAKER CITY, OR
NPI
1619757879
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR T-23-3155)
Enumeration Date
2023-10-04
Last Update Date
2023-10-04
Business Address
SHANNON RUTH MARTINEZ
3610 MIDWAY DR
BAKER CITY, OR 97814-1466
Phone number: 541-523-6581
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Mailing Address
SHANNON RUTH MARTINEZ
3425 13TH ST
BAKER CITY, OR 97814-1340
Phone number: 541-523-7400
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