Healthcare Provider Details

I. General information

NPI: 1114855533
Provider Name (Legal Business Name): JOSEPH NDIRANGU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1593 JORDAN DR S
SALEM OR
97302-2329
US

IV. Provider business mailing address

1593 JORDAN DR S
SALEM OR
97302-2329
US

V. Phone/Fax

Practice location:
  • Phone: 508-488-7430
  • Fax:
Mailing address:
  • Phone: 508-488-7430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: