Individual
DONALD ENDICOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3600 13TH ST, BAKER CITY, OR 97814-1346
(541) 523-6680
Mailing address
3600 13TH ST, BAKER CITY, OR 97814-1346
(541) 523-6680
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10- P-05
OR
Other
Enumeration date
02/08/2016
Last updated
02/08/2016
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