Individual
JOHN CHARLES RIDDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC I
Contact information
Practice address
2035 DAVCOR ST SE, SALEM, OR 97302-1595
(503) 576-4660
(503) 361-2688
Mailing address
1575 19TH ST NE, SALEM, OR 97301-7931
(503) 585-6255
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/02/2012
Last updated
03/02/2012
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