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Dustin Garrett Fortado, CRM
Peer Specialist in Medford, Oregon
NPI 1538662614

Dustin Garrett Fortado is a Peer Specialist based in Medford, OR. Dustin Garrett Fortado practices in Medford, OR and has the professional credentials of CRM. The NPI Number for Dustin Garrett Fortado is 1538662614 and holds a License No. (Oregon).

The current practice location address for Dustin Garrett Fortado is 1025 E Main St, Medford, OR and can be reached out via phone at 541-779-1282.

Location: 1025 E Main St, Medford, OR, 97504-7140
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1538662614
Provider Name
Dustin Garrett Fortado
Credential
CRM
Provider Entity Type
Individual
Gender
Male
Address
1025 E Main St, Medford, OR, 97504-7140
Phone Number
541-779-1282
Fax Number
Provider Enumeration Date
03/14/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1025 E Main St
City
Medford
State
Oregon
Zip
97504-7448
Phone Number
541-779-1282
Fax Number
person
Provider Business Mailing Address Details
Address
1025 E Main St
City
Medford
State
Oregon
Zip
97504-7448
Phone Number
541-779-1282
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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