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Individual

DELLA M RADKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
QMHA

Contact information

Practice address
4890 32ND AVE SE, SALEM, OR 97317-9350
(503) 588-5647
(503) 588-0509
Mailing address
4890 32ND AVE SE, SALEM, OR 97317-9350
(503) 588-5647
(503) 588-0509

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
172V00000X
Community Health Worker

Other

Enumeration date
11/19/2013
Last updated
02/20/2015
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