Individual
MICHAEL EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
158 W OLIVE ST, NEWPORT, OR 97365-3824
(541) 272-3740
Mailing address
158 W OLIVE ST, NEWPORT, OR 97365-3824
(541) 272-3740
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OR
Other
Enumeration date
08/22/2024
Last updated
08/22/2024
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