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General NPI Number Information
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NPI Number | 1346108156
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Entity Type | Individual
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Provider Name | DUSTIN ARON LOONEY CRM
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Gender | Male
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 500 SE CASS AVE STE 100
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City | ROSEBURG
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State | OR
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Zip | 97470-3175
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Country | US
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Telephone | 541-677-5520
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Fax | 855-670-1788
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Provider Business Mailing Address
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Address Line | 2589 NW EDENBOWER BLVD
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City | ROSEBURG
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State | OR
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Zip | 97471-6224
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Country | US
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Telephone | 541-529-9190
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Fax | 541-529-9190
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | 24-CRM-3772
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License Number State | OR
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