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Individual

DEBRA ROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3325 HAROLD DR NE, SALEM, OR 97305-1339
(503) 363-2021
Mailing address
PO BOX 17818, SALEM, OR 97305-7818
(503) 363-2021

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
19-03-08
OR
175T00000X
Peer Specialist
Primary
19-CGRM-001
OR

Other

Enumeration date
06/07/2019
Last updated
06/07/2019
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