Individual
CONRAD M DOUMA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC I
Contact information
Practice address
107 SE SWAN, SILETZ, OR 97380
(541) 444-1030
(541) 444-9695
Mailing address
PO BOX 320, SILETZ, OR 97380-0320
(541) 444-1030
(541) 444-9695
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
99-11-10
OR
Other
Enumeration date
04/09/2007
Last updated
07/08/2007
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