Individual
JOHN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC
Contact information
Practice address
908 NE 4TH ST STE 101, BEND, OR 97701-4646
(541) 617-7365
Mailing address
340 NW 5TH ST STE 203, REDMOND, OR 97756-1869
(541) 516-4087
(541) 504-1195
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16-12-11
OR
Other
Enumeration date
07/27/2018
Last updated
07/27/2018
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