Individual
GUSTAVO ADRIAN ENRIQUEZ URIBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
116 SE D ST, MADRAS, OR 97741-1699
(541) 615-2650
(541) 777-6169
Mailing address
850 SW 4TH ST, MADRAS, OR 97741-9628
(541) 475-6575
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
26-01-11771
OR
Other
Enumeration date
02/04/2026
Last updated
02/04/2026
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