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Marty Ray Boehlke, THW
Peer Specialist in Fossil, Oregon
NPI 1154039584

Marty Ray Boehlke is a Peer Specialist based in Heppner, OR. Marty Ray Boehlke practices in Fossil, OR and has the professional credentials of THW. The NPI Number for Marty Ray Boehlke is 1154039584 and holds a License No. (Oregon).

The current practice location address for Marty Ray Boehlke is 401 Fourth St, Fossil, OR and can be reached out via phone at 541-763-2746 and via fax at 541-763-2170.

Location: 401 Fourth St, Fossil, OR, 97836-0469
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1154039584
Provider Name
Marty Ray Boehlke
Credential
THW
Provider Entity Type
Individual
Gender
Male
Address
401 Fourth St, Fossil, OR, 97836-0469
Phone Number
541-763-2746
Fax Number
541-763-2170
Provider Enumeration Date
11/15/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
401 Fourth St
City
Fossil
State
Oregon
Zip
97830-8302
Phone Number
541-763-2746
Fax Number
541-763-2170
person
Provider Business Mailing Address Details
Address
401 Fourth St
City
Fossil
State
Oregon
Zip
97830-8302
Phone Number
541-763-2746
Fax Number
541-763-2170
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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