Individual
MR. EDWAR JOSE FERNANDO ESTUPINIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2225 PACIFIC BLVD SE, ALBANY, OR 97321-7907
(541) 286-5002
Mailing address
2225 PACIFIC BLVD SE STE 101, ALBANY, OR 97321-7903
(541) 286-5002
(541) 246-8826
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
C6204
OR
Other
Enumeration date
02/21/2018
Last updated
06/22/2021
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