Individual
MR. BRIAN WAYNE PHIFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 SERENITY LN, COBURG, OR 97408-9350
(541) 687-1110
Mailing address
2257 JENNY LN, EUGENE, OR 97402-8236
(541) 510-5085
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-20-424
OR
175T00000X
Peer Specialist
—
—
Other
Enumeration date
07/22/2019
Last updated
01/14/2021
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