Individual
MICHAEL LILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
125 SW C ST, MADRAS, OR 97741-1458
(541) 475-6575
(541) 504-1195
Mailing address
125 SW C ST, MADRAS, OR 97741-1458
(541) 475-6575
(541) 504-1195
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/05/2014
Last updated
09/05/2014
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