Individual
JASON IVEANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
365 NE COURT ST, PRINEVILLE, OR 97754-1936
(541) 323-5330
(541) 447-6694
Mailing address
365 NE COURT ST, PRINEVILLE, OR 97754-1936
(541) 323-5330
(541) 447-6694
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/20/2012
Last updated
06/20/2012
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