Individual
KEITH WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC II
Contact information
Practice address
2107 WASHINGTON AVE, LA GRANDE, OR 97850-2954
(541) 805-0252
Mailing address
2107 WASHINGTON AVE, LA GRANDE, OR 97850-2954
(541) 805-0252
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10-06-71
OR
Other
Enumeration date
02/14/2017
Last updated
02/14/2017
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