Healthcare Provider Details

I. General information

NPI: 1821114836
Provider Name (Legal Business Name): MICHAEL OYSTER LPC, CADC III
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 08/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

344 NW 6TH ST
CORVALLIS OR
97330-4814
US

IV. Provider business mailing address

344 NW 6TH ST
CORVALLIS OR
97330-4814
US

V. Phone/Fax

Practice location:
  • Phone: 541-207-6212
  • Fax:
Mailing address:
  • Phone: 541-207-6212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCADC III, 95-04-154
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC1482
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: