Individual
KENNETH CLIFTON PATTERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
THW000104598
Contact information
Practice address
2555 SILVERTON RD NE, SALEM, OR 97301-0837
(503) 573-7018
Mailing address
2555 SILVERTON RD NE, SALEM, OR 97301-0837
(503) 573-7018
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000104598
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
THW000105498
OHA OFFICE OF EQUITY AND INCLUSION TRADITIONAL HEALTH WORKER
OR
Enumeration date
07/15/2021
Last updated
07/15/2021
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