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1962924324
KEDWARD HAINES
SALEM, OR
NPI
1962924324
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR 17-05-08)
Enumeration Date
2017-07-07
Last Update Date
2022-07-21
Business Address
KEDWARD HAINES
3871 FAIRVIEW INDUSTRIAL DR SE STE 150
SALEM, OR 97302-1172
Phone number: 503-391-9762
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Mailing Address
KEDWARD HAINES
3871 FAIRVIEW INDUSTRIAL DR SE STE 150
SALEM, OR 97302-1172
Phone number: 503-391-9762
Copy
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