SearchOregon101YA0400X

Korben Chesnut-Petry, CADC 1

NPI 1841805959 · on the registry since 2020 · sole proprietor

Practice

Address
1325 Commercial St Se
Salem, OR 97302
Phone
(971) 301-9574

Registry record

Primary taxonomy
101YA0400X
101YA0400X
Licence states on file
OR
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2020-09-15

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon