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Individual

JOSEPH COVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3325 HAROLD DR NE, SALEM, OR 97305-1339
(503) 363-2021
(503) 363-4820
Mailing address
3325 HAROLD DR NE, PO BOX 17818, SALEM, OR 97305-1339
(503) 363-2021
(503) 363-4820

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
26-3634042
OR
Enumeration date
03/11/2015
Last updated
03/11/2015
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