Individual
MR. MARCO GONZALEZ-KENSLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4455 NE HIGHWAY 20, CORVALLIS, OR 97330-9695
(541) 758-5900
Mailing address
2004 FRONT AVE NE, ALBANY, OR 97321-4725
(541) 905-6639
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/04/2012
Last updated
02/04/2012
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