Individual
NATHANIEL ALLEN LACUESTA SHERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1755 LOCKHAVEN DR NE, KEIZER, OR 97303-2071
(503) 851-8585
Mailing address
1740 SHAFF RD # 233, STAYTON, OR 97383-1092
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
10/22/2024
Last updated
10/22/2024
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