Individual
MR. THOMAS GEORGE STUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
2400 LANCASTER DR NE, SALEM, OR 97305-1221
(503) 361-5400
Mailing address
3595 CRESTVIEW DR S, SALEM, OR 97302-5658
(503) 399-1603
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
OR 96-10-165
OR
Other
Enumeration date
08/15/2006
Last updated
07/08/2007
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