Individual
SALVADOR AMEZOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC II
Contact information
Practice address
340 NW 5TH ST, BOX 1710, REDMOND, OR 97756-1869
(541) 516-4087
(541) 504-1195
Mailing address
236 SE D ST, MADRAS, OR 97741-1619
(541) 475-5300
(540) 504-1195
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
02 P 03
OR
Other
Enumeration date
10/07/2015
Last updated
10/07/2015
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