Individual
TREVER WADE HOUGHTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2555 SILVERTON RD NE, SALEM, OR 97301-0837
(503) 393-4273
Mailing address
1115 MADISON ST NE # 222, SALEM, OR 97301-7862
(503) 393-4273
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/07/2018
Last updated
08/07/2018
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