Individual
LISA J BJORNSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
530 NW 27TH ST, CORVALLIS, OR 97330-5223
(541) 766-6835
(541) 766-6186
Mailing address
PO BOX 579, CORVALLIS, OR 97339-0579
(541) 766-6835
(541) 766-6186
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
99-03-21
OR
106H00000X
Marriage & Family Therapist
Primary
R1900 (INTERN)
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
99-03-21
CERTIFIED A&D COUNSELOR
OR
Enumeration date
12/04/2006
Last updated
01/11/2012
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