Individual
NAOMI NICOLE FORSYTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3610 MIDWAY DR, BAKER CITY, OR 97814-1466
(541) 523-6581
(541) 523-9237
Mailing address
3425 13TH ST, BAKER CITY, OR 97814-1340
(541) 523-7400
(541) 523-4927
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
23-11-10951
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500813135
—
OR
01
—
8450589
ODL
OR
Enumeration date
11/15/2022
Last updated
04/08/2024
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