Individual
MYKAH DEAN KRUMWIEDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC-R
Contact information
Practice address
435 E NEWPORT AVE, HERMISTON, OR 97838-2487
(541) 564-9390
(541) 564-9384
Mailing address
PO BOX 469, HEPPNER, OR 97836-0469
(541) 676-9161
(541) 676-5662
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-25-3134
OR
Other
Enumeration date
10/28/2024
Last updated
10/28/2024
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