Individual
SHANNON MATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC I
Contact information
Practice address
125 SW C ST, MADRAS, OR 97741-1458
(541) 475-6575
(541) 504-1195
Mailing address
125 SW C ST, MADRAS, OR 97741-1458
(541) 475-6575
(541) 504-1195
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15-01-07
OR
Other
Enumeration date
04/28/2015
Last updated
04/28/2015
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