Individual
TERESA W SYVERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC I
Contact information
Practice address
906 MAIN AVE, TILLAMOOK, OR 97141-3816
(503) 842-8201
(503) 815-1870
Mailing address
9875 CHANCE RD, TILLAMOOK, OR 97141
(503) 842-8201
(503) 815-1870
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197749
—
OR
Enumeration date
03/02/2007
Last updated
07/09/2007
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