Individual
KIM SHAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
460 LANCASTER DR NE, SALEM, OR 97301-4728
(503) 584-1906
Mailing address
3431 BLUFF AVE SE, SALEM, OR 97302-3326
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
C0492
OR
101YP2500X
Professional Counselor
Primary
C0492
OR
Other
Enumeration date
07/07/2009
Last updated
07/07/2009
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