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NPI Code Detail

MEDICARE: CHANCE HOLLOWELL CRM

MEDICARE: CHANCE HOLLOWELL CRM
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
1101YA0400XAddiction (Substance Use Disorder) CounselorOR

General Provider Information

NPI Number : 1477498061
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHANCE HOLLOWELL CRM
Provider Business Mailing Address
First Line : 547 SW 7TH ST
Second Line :
City : NEWPORT
State : OR
Zip : 97365-4909
Country : US
Telephone Number : 541-961-9979
Fax Number : 541-574-8857
Provider Business Practice Location Address
First Line : 547 SW 7TH ST
Second Line :
City : NEWPORT
State : OR
Zip : 97365-4909
Country : US
Telephone Number : 541-961-9979
Fax Number : 541-574-8857
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2026
Last Update Date : 04/21/2026

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Directions to “ CHANCE HOLLOWELL CRM” Practice Location

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