Individual
ANTONIO GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
850 SW 4TH ST STE 201, MADRAS, OR 97741-9629
(541) 475-6575
(541) 475-6196
Mailing address
850 SW 4TH ST STE 201, MADRAS, OR 97741-9629
(541) 475-6575
(541) 475-6196
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
22-05-10400
OR
Other
Enumeration date
02/09/2023
Last updated
02/09/2023
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