Healthcare Provider Details

I. General information

NPI: 1750208666
Provider Name (Legal Business Name): ANA MICHELLE BUENO-SALAZAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 W SPERRY STREET
HEPPNER OR
97836
US

IV. Provider business mailing address

84014 HIGHWAY 339
MILTON FREEWATER OR
97862-7666
US

V. Phone/Fax

Practice location:
  • Phone: 541-676-9161
  • Fax:
Mailing address:
  • Phone: 509-520-8201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberNO.26-QMHP-R-4285
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: