Individual
CHARLES WILLIAM HEMINGWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NCC, MAC, CADC III
Contact information
Practice address
59939 MINNETONKA CIR, BEND, OR 97702-9196
(541) 318-1897
Mailing address
1854 NE DIVISION ST, BEND, OR 97701-3502
(541) 388-2096
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
09-12-70
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09-12-70
STATE CERTIFIED AOD COUNSELOR
OR
Enumeration date
07/02/2019
Last updated
07/02/2019
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