Individual
JONEL WALDRUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, QMHA
Contact information
Practice address
2210 N ELDORADO AVE, KLAMATH FALLS, OR 97601
(541) 883-1030
(541) 884-2338
Mailing address
2210 N ELDORADO AVE, KLAMATH FALLS, OR 97601-6418
(541) 883-1030
(541) 884-2338
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720105489
—
OR
Enumeration date
12/02/2014
Last updated
06/05/2018
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