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Organization

TAHANA WHITECROW FOUNDATION

Active
Other names
Tahana Whitecrow Outpatient
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MELANIE MAE SMITH CADCII NCACI (DIRECTOR SUBSTANCE ABUSE COUNSELOR)
(503) 585-0564
Entity
Organization

Contact information

Practice address
2350 WALLACE RD NW, SALEM, OR 97304-2127
(503) 585-0564
(503) 585-3302
Mailing address
2350 WALLACE RD NW, SALEM, OR 97304-2127
(503) 585-0564
(503) 585-3302

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
132832
OR
Enumeration date
11/10/2005
Last updated
08/22/2020
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