Individual
MICHAEL JOHN WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC 1
Contact information
Practice address
720 NW 6TH ST, GRANTS PASS, OR 97526-1524
(541) 237-5062
(541) 955-7499
Mailing address
106 NW F ST # 87, GRANTS PASS, OR 97526-2012
(541) 450-7204
(541) 479-2370
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
175T00000X
Peer Specialist
THW000002886
OR
247000000X
Health Information Technician
—
—
Other
Enumeration date
07/28/2018
Last updated
10/30/2020
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