Ketrick Devon Pendergrass I
Counselor - Addiction (Substance Use Disorder)
About Ketrick Devon Pendergrass I
Ketrick Devon Pendergrass I is a male healthcare professional specializing in Counselor - Addiction (Substance Use Disorder) with a focus on Addiction (Substance Use Disorder), registered under National Provider Identifier (NPI) number 1992412035.
Their primary practice is located at 1 SERENITY LN, Coburg, Oregon 97408. Patients can reach the office at (541) 687-1110. Ketrick Devon Pendergrass I has been NPI-registered since 2022.
Doctor Details
Identity & Credentials
- NPI Number
- 1992412035
- Entity Type
- Individual
- First Name
- Ketrick
- Last Name
- Pendergrass
- Gender
- Male
- Sole Proprietor
- No
- Status
- active
Primary Practice Location
- Address
- 1 SERENITY LN
- City
- Coburg
- State
- Oregon
- ZIP
- 97408-9350
- Country
- United States
- Phone
- (541) 687-1110
Specialty & Taxonomy
- Primary Specialty
- Counselor - Addiction (Substance Use Disorder)
- Classification
- Counselor
- Specialization
- Addiction (Substance Use Disorder)
- Taxonomy Code
- 101YA0400X
NPI Registration
- Enumeration Date
- Last Updated
- Certification Date
Mailing Address
- Address
- 1 SERENITY LN
- City
- COBURG
- State
- OR
- ZIP
- 974089350
Medicare Enrollment
- Medicare Enrolled
- No
- Can Order/Refer
- No
- Telehealth
- No
- Excluded
- No
Frequently Asked Questions
What is Ketrick Devon Pendergrass I's NPI number?
What does Ketrick Devon Pendergrass I specialize in?
Where is Ketrick Devon Pendergrass I located?
Does Ketrick Devon Pendergrass I accept Medicare?
Does Ketrick Devon Pendergrass I offer telehealth or virtual visits?
What is an NPI Number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to healthcare providers in the United States by the Centers for Medicare & Medicaid Services (CMS). Required under HIPAA, every healthcare provider who transmits health information electronically must have an NPI. The NPI for Ketrick Devon Pendergrass I is 1992412035.