Individual
SCOTT WILLISTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, QMHP
Contact information
Practice address
200 BEATTY ST, MEDFORD, OR 97501-5811
(541) 476-3302
Mailing address
1215 SW G ST, GRANTS PASS, OR 97526-2544
(541) 476-2373
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C7267
OR
Other
Enumeration date
09/21/2016
Last updated
02/12/2024
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