Individual
PATRICK SECREST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1885 NE 7TH ST, GRANTS PASS, OR 97526-3403
(541) 660-5420
Mailing address
1885 NE 7TH ST, GRANTS PASS, OR 97526-3403
(541) 660-5420
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
20-03-14
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-03-14
MHACBO
OR
Enumeration date
08/05/2021
Last updated
08/05/2021
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