Individual
GERAMIE MARK MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRM II, CADC-R
Contact information
Practice address
91150 N COBURG INDUSTRIAL WAY, COBURG, OR 97408-9512
(541) 284-5645
Mailing address
91150 N COBURG INDUSTRIAL WAY, COBURG, OR 97408-9512
(541) 606-6281
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-23-2430
OR
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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