Individual
EDGAR PINEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPS
Contact information
Practice address
340 NW 5TH ST, BOX 710, REDMOND, OR 97756-1869
(541) 516-4087
(541) 504-1195
Mailing address
340 NW 5TH ST, PO BOX 710, REDMOND, OR 97756-1869
(541) 516-4087
(541) 504-1195
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13 CPS 005
OR
Other
Enumeration date
09/24/2015
Last updated
09/24/2015
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