Individual
MR. GRAHAM NELSON RETASKET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
182 SW ACADEMY ST, DALLAS, OR 97338-1996
(503) 962-3928
Mailing address
300 SE GOODNIGHT AVE UNIT 29, CORVALLIS, OR 97333-2191
(503) 975-1476
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/04/2024
Last updated
01/04/2024
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