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Individual

MR. KEITH M IRWIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA, QMHP

Contact information

Practice address
2001 COMMERCIAL ST SE # 200, SALEM, OR 97302-5207
(503) 370-8050
(503) 370-9982
Mailing address
2001 COMMERCIAL ST SE # 200, SALEM, OR 97302-5207
(503) 370-8050
(503) 370-9982

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C4798
OR
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
12/18/2008
Last updated
03/18/2026
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