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Raul Bernardo Diestra
Peer Specialist in Salem, Oregon
NPI 1497251151

Raul Bernardo Diestra is a Peer Specialist based in Salem, OR. Raul Bernardo Diestra practices in Salem, OR. The NPI Number for Raul Bernardo Diestra is 1497251151 and holds a License No. (Oregon).

The current practice location address for Raul Bernardo Diestra is 1118 Oak St Se, Salem, OR and can be reached out via phone at 503-358-4850.

Location: 1118 Oak St Se, Salem, OR, 97301-4019
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1497251151
Provider Name
Raul Bernardo Diestra
Credential
Provider Entity Type
Individual
Gender
Male
Address
1118 Oak St Se, Salem, OR, 97301-4019
Phone Number
503-358-4850
Fax Number
Provider Enumeration Date
04/02/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
122994 05 OR
institution
Provider Business Practice Location Address Details
Address
1118 Oak St Se
City
Salem
State
Oregon
Zip
97301-4019
Phone Number
503-358-4850
Fax Number
person
Provider Business Mailing Address Details
Address
1118 Oak St Se
City
Salem
State
Oregon
Zip
97301-4019
Phone Number
503-358-4850
Fax Number
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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