Individual
KEDWARD HAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3871 FAIRVIEW INDUSTRIAL DR SE STE 150, SALEM, OR 97302-1172
(503) 391-9762
Mailing address
3871 FAIRVIEW INDUSTRIAL DR SE STE 150, SALEM, OR 97302-1172
(503) 391-9762
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17-05-08
OR
Other
Enumeration date
07/07/2017
Last updated
07/21/2022
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