Individual
MR. WILLIAM C. POULTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC II-ACCBO (OREGO
Contact information
Practice address
548 SW JACKSON ST, ROSEBURG, OR 97470-2709
(541) 672-2691
(541) 673-5642
Mailing address
PO BOX 1121, ROSEBURG, OR 97470-0254
(541) 672-2691
(541) 673-5642
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
96-04-122
OR
Other
Enumeration date
02/04/2016
Last updated
02/04/2016
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