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Individual

BRUCE SHANE OSTLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1060 WEBBER ST, THE DALLES, OR 97058-3749
(541) 296-5452
(541) 296-5263
Mailing address
965 TUCKER RD, HOOD RIVER, OR 97031
(541) 386-6665

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YM0800X
Mental Health Counselor
Primary
25-QMHP-R-3672
OR
171M00000X
Case Manager/Care Coordinator
24-QMHA-I-004128
OR
175T00000X
Peer Specialist
112437
OR

Other

Enumeration date
08/18/2021
Last updated
06/19/2025
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