Individual
MICAH BOMBARDIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
QMHA
Contact information
Practice address
445 3RD AVE SW, ALBANY, OR 97321-2272
(541) 967-3866
Mailing address
PO BOX 100, ALBANY, OR 97321-0031
(541) 967-3866
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/08/2021
Last updated
02/02/2024
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