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Individual

MICHAEL SHANE IDDINGS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1420 GREEN ACRES RD, EUGENE, OR 97408-1791
(541) 762-4511
Mailing address
687 CHESHIRE AVE, EUGENE, OR 97402-5060

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
OR

Other

Enumeration date
08/02/2024
Last updated
08/02/2024
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