Individual
ORIE MADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRM
Contact information
Practice address
185 NW D ST, SUITE D&E, MADRAS, OR 97741
(541) 306-4566
Mailing address
1435 NE 4TH ST STE B, BEND, OR 97701-4268
(541) 306-4446
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18-CRM-124
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
18CRM124
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18CRM124
STATE OF OREGON
OR
Enumeration date
07/27/2018
Last updated
07/27/2018
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