Healthcare Provider Details

I. General information

NPI: 1194351817
Provider Name (Legal Business Name): ROXANNA J HOYT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ROXANNA J BARNES

II. Dates (important events)

Enumeration Date: 03/13/2020
Last Update Date: 02/18/2021
Certification Date: 02/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 SW DORION AVE
PENDLETON OR
97801-2070
US

IV. Provider business mailing address

PO BOX 882
PENDLETON OR
97801-0882
US

V. Phone/Fax

Practice location:
  • Phone: 541-429-8800
  • Fax: 541-429-8822
Mailing address:
  • Phone: 541-429-8844
  • Fax: 541-278-6330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberT-20-188
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number20-CRM-047
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: