Individual
SHANE DOUGLAS ROUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
195 W 12TH AVE, EUGENE, OR 97401-3408
(541) 762-4300
Mailing address
687 CHESHIRE AVE, EUGENE, OR 97402-5060
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-22-1832
OR
Other
Enumeration date
03/07/2024
Last updated
03/07/2024
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