Individual
DAVID AMITY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
104 4TH AVE SW, ALBANY, OR 97321-2804
(541) 967-3819
Mailing address
PO BOX 100, ALBANY, OR 97321-0031
(541) 967-3819
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
98-07-01
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101279
—
OR
Enumeration date
03/03/2014
Last updated
03/03/2014
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