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General NPI Number Information
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NPI Number | 1447045299
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Entity Type | Individual
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Provider Name | DUSTIN M VARHAUL CRM
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Gender | Male
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Dates
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Enumeration Date | 04/11/2025
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Last Update Date | 03/03/2026
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Provider Practice Location Address
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Address Line | 5105 MAIN ST
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City | SPRINGFIELD
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State | OR
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Zip | 97478-6214
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Country | US
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Telephone | 541-357-4603
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Fax | 541-995-5013
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Provider Business Mailing Address
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Address Line | 230 N 3RD ST STE 105
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City | HARRISBURG
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State | OR
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Zip | 97446-9679
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Country | US
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Telephone | 541-357-4603
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Fax | 541-995-5013
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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-3723
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | T-26-6470
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License Number State | OR
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