Individual
KRISTEN WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC II, QMHA
Contact information
Practice address
1011 COMMERCIAL ST NE STE 110, SALEM, OR 97301-1036
(503) 983-9900
(503) 983-9899
Mailing address
1011 COMMERCIAL ST NE STE 110, SALEM, OR 97301-1036
(039) 839-9900
(503) 983-9900
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13-12-73
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790247054
—
OR
Enumeration date
04/04/2019
Last updated
04/05/2021
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