Individual
KYLE ANDREW TOMASELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADCR
Contact information
Practice address
525 FERRY ST SE, SALEM, OR 97301-3773
(503) 363-6103
(503) 363-0833
Mailing address
525 FERRY ST SE, SALEM, OR 97301-3773
(503) 363-6103
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-22-2128
OR
Other
Enumeration date
11/16/2022
Last updated
11/16/2022
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