Individual
JORGE MONTEJANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC-R, QMHA-R
Contact information
Practice address
223 COMMERCIAL ST NE, SALEM, OR 97301-3411
(503) 540-5554
Mailing address
PO BOX 17818, SALEM, OR 97305-7818
(503) 540-5554
(503) 689-1587
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-19-2017
OR
101YM0800X
Mental Health Counselor
20-QMHA-R-0316
OR
Other
Enumeration date
07/13/2020
Last updated
07/13/2020
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