Individual
KENNETH M BAKONDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
557 NW MONROE AVE, CORVALLIS, OR 97330-4721
(541) 766-6147
Mailing address
2010 SW 3RD ST UNIT 21, CORVALLIS, OR 97333-1789
(541) 752-1705
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/14/2010
Last updated
10/14/2010
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