Individual
MR. LAWRENCE SQUIEMPHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC I
Contact information
Practice address
125 SW C ST, MADRAS, OR 97741-1458
(541) 306-4566
(541) 320-9005
Mailing address
1435 NE 4TH ST STE B, BEND, OR 97701-4268
(541) 306-4446
(541) 550-2011
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-17-163
OR
Other
Enumeration date
10/16/2018
Last updated
03/13/2019
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