ERNST UDEY SHADBOLT

ROSEBURG, OR
NPI1639536691
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR  08-03-32)
Enumeration Date2016-01-21
Last Update Date2016-01-21
Business Address
-- ERNST UDEY SHADBOLT CADC I
2064 SE DOUGLAS AVE
ROSEBURG, OR 97470-3713
Phone number: 541-673-5119
Mailing Address
-- ERNST UDEY SHADBOLT CADC I
PO BOX 1121
ROSEBURG, OR 97470-0254
Phone number: 541-673-5119