Individual
MR. NATHANIEL KRAVITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, MN, PMHNP
Contact information
Practice address
2045 SILVERTON RD NE, SALEM, OR 97301-0100
(503) 588-5351
(503) 585-4908
Mailing address
1587 PACIFIC RIDGE LN SE, JEFFERSON, OR 97352-9654
(503) 361-7758
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
23426
OR
163WP0808X
Psychiatric/Mental Health Registered Nurse
200841283RN
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201050130NP
OR
Other
Enumeration date
08/10/2009
Last updated
07/29/2019
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