MEDICARE: CHAD AARON MART MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1033409446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAD AARON MART MA

Provider Business Mailing Address
First Line	:	3995 MARCOLA RD
Second Line	:
City	:	SPRINGFIELD
State	:	OR
Zip	:	97477-1522
Country	:	US
Telephone Number	:	541-726-1465
Fax Number	:

Provider Business Practice Location Address
First Line	:	3995 MARCOLA RD.
Second Line	:
City	:	SPRINGFIELD
State	:	OR
Zip	:	97477-9751
Country	:	US
Telephone Number	:	541-726-1465
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2011
Last Update Date	:	06/26/2023

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Directions to “ CHAD AARON MART MA” Practice Location

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