Individual
JONATHAN ANDREW LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1144 CENTER ST NE, SALEM, OR 97301-2523
(503) 363-2021
Mailing address
PO BOX 17818, SALEM, OR 97305-7818
(503) 363-2021
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-25-4804
OR
Other
Enumeration date
04/08/2024
Last updated
01/14/2025
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