Individual
SPENCER J DE LOS REYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
613 N 1ST AVE, STAYTON, OR 97383-1704
(503) 363-2021
Mailing address
613 N 1ST AVE, STAYTON, OR 97383-1704
(503) 363-2021
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/25/2024
Last updated
06/05/2025
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