Individual
PATRICIA IRMA VERA GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADCII
Contact information
Practice address
775 SW MADISON ST, MADRAS, OR 97741-1028
(503) 866-4642
Mailing address
775 SW MADISON ST, MADRAS, OR 97741-1028
(503) 866-4642
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11-P-18
OR
Other
Enumeration date
09/13/2023
Last updated
10/16/2023
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