Individual
KRISTOFER RICHARD BLANKENSHIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRM, CADC-R
Contact information
Practice address
433 3RD AVE SE, ALBANY, OR 97321-2860
(541) 791-7193
Mailing address
433 3RD AVE SE, ALBANY, OR 97321-2860
(541) 791-7193
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-22-2097
OR
Other
Enumeration date
11/01/2022
Last updated
11/01/2022
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