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1851027411
JUSTYN REID STATEN
PRINEVILLE, OR
NPI
1851027411
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR 21-11-10279)
Enumeration Date
2022-07-26
Last Update Date
2022-09-15
Business Address
JUSTYN REID STATEN CADC-I, PSS, CRM
1333 NW 9TH ST
PRINEVILLE, OR 97754-1482
Phone number: 541-447-2631
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Mailing Address
JUSTYN REID STATEN CADC-I, PSS, CRM
1356 NW DAVENPORT AVE
BEND, OR 97703-3077
Phone number: 541-699-9226
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