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General NPI Number Information
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NPI Number | 1356851042
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Entity Type | Individual
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Provider Name | DEBRA MONAGHAN
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Gender | Female
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Dates
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Enumeration Date | 10/06/2017
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Last Update Date | 10/06/2017
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Provider Practice Location Address
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Address Line | 1271 SW 9TH ST
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City | WARRENTON
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State | OR
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Zip | 97146-9418
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Country | US
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Telephone | 503-861-4291
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Fax |
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Provider Business Mailing Address
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Address Line | 1271 SW 9TH ST
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City | WARRENTON
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State | OR
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Zip | 97146-9418
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Country | US
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Telephone | 503-861-4291
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Fax |
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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 | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 136551892
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License Number State | OR
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