Healthcare Provider Details

I. General information

NPI: 1760771927
Provider Name (Legal Business Name): ADALBERTO MONTES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2011
Last Update Date: 09/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 E 11TH AVE
EUGENE OR
97401-3247
US

IV. Provider business mailing address

2250 FOUR OAKS GRANGE RD
EUGENE OR
97405-1015
US

V. Phone/Fax

Practice location:
  • Phone: 541-484-4428
  • Fax: 541-484-7212
Mailing address:
  • Phone: 541-912-9992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: