IndividualActive
Antonio Gentry
NPI 1366149403 · Addiction (Substance Use Disorder) Counselor · Madras, OR
Provider details
- NPI number
- 1366149403
- Entity type
- Individual
- Primary specialty
- Addiction (Substance Use Disorder) CounselorBehavioral Health & Social Service Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 22-05-10400 (OR)
Practice location
850 Sw 4th St Ste 201
Madras, OR 97741-9629
Phone: (541) 475-6575
Fax: (541) 475-6196
Mailing address
850 Sw 4th St Ste 201
Madras, OR 97741-9629
Registry dates
- Enumerated
- 2023-02-09
- Last updated
- 2023-02-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.