Gary Kieser

Individual provider Active NPI Counselor · Independence, OR

NPI 1023338043 · NPPES record last updated Jun 2, 2010

Key facts

NPI
1023338043
Entity type
Individual (NPI type 1)
Primary specialty
Counselor 101Y00000X
Practice address
460 Greenwood Rd S
Independence, OR 97351-9653
Phone
(503) 838-6431
Fax
(503) 838-6440
NPI assigned
Jun 2, 2010
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Polk, Yamhill, & Marion Treatment Services Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Yes

Addresses

Primary practice location

460 Greenwood Rd S
Independence, OR 97351-9653

Mailing address

460 Greenwood Rd S
Independence, OR 97351-9653
Phone (503) 838-6431

Other providers in Independence, OR

All providers in Independence, OR · Counselor in Oregon

Sources for this page

Verify at the official NPI Registry.