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Organization

WILLAMETTE VALLEY TREATMENT CENTER, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JAY M LAWSHE LPN/CADCII/NCACII (EXECUTIVE PROGRAM DIRECTOR/SPONSOR)
(503) 391-9762
Entity
Organization

Contact information

Practice address
115 LANCASTER DR NE, SALEM, OR 97301-5110
(503) 391-9762
(503) 315-2019
Mailing address
115 LANCASTER DR NE, SALEM, OR 97301-5110
(503) 391-9762
(503) 315-2019

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
OR10-036M
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
227068
OR
Enumeration date
08/29/2006
Last updated
08/22/2020
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