Individual
MR. VERNON ROSE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC II
Contact information
Practice address
4211 W 11TH AVE, EUGENE, OR 97402-5435
(541) 485-1577
(541) 242-2853
Mailing address
4211 W 11TH AVE, EUGENE, OR 97402-5435
(541) 485-1577
(541) 242-2853
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
07-09-64
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07-09-64
CERTIFIED ALCOHOL AND DRUG COUNSELOR LEVEL II
OR
05
—
500730386
—
OR
Enumeration date
03/21/2017
Last updated
10/29/2020
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