Individual
DAVE AUTREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
461 NE GREENWOOD AVE, BEND, OR 97701
(541) 617-7365
(541) 312-6343
Mailing address
51950 PACIFIC WILLOW, LA PINE, OR 97739-9425
(541) 617-7365
(541) 312-6343
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
98-R-05
OR
Other
Enumeration date
06/01/2007
Last updated
07/08/2007
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