Individual
MR. ROGER BANTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1233 EDGEWATER ST NW, SALEM, OR 97304
(503) 378-7526
(503) 480-1630
Mailing address
3872 ASH AVE SE, SALEM, OR 97302-4703
(206) 650-1543
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L7065
OR
Other
Enumeration date
10/25/2012
Last updated
07/16/2024
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