Individual
KEVIN STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
627 NE EVANS ST, MCMINNVILLE, OR 97128-3923
(503) 434-7523
Mailing address
627 NE EVANS ST, MCMINNVILLE, OR 97128-3923
(503) 434-7523
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CADCIII 94-0634
OR
Other
Enumeration date
03/14/2007
Last updated
07/08/2007
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