Individual
BRYAN DEWITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRM
Contact information
Practice address
2301 COVE AVE, LA GRANDE, OR 97850-3906
(541) 962-8800
(541) 963-5272
Mailing address
2301 COVE AVE, LA GRANDE, OR 97850-3906
(541) 962-8800
(541) 963-5272
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-25-6031
OR
175T00000X
Peer Specialist
—
—
Other
Enumeration date
08/26/2024
Last updated
03/04/2026
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