person
Dustin A Shadley
Peer Specialist in Medford, Oregon
NPI 1841648516

Dustin A Shadley is a Peer Specialist based in Medford, OR. Dustin A Shadley practices in Medford, OR. The NPI Number for Dustin A Shadley is 1841648516 and holds a License No. (Oregon).

The current practice location address for Dustin A Shadley is 140 S Holly Street, Medford, OR and can be reached out via phone at 541-774-8201 and via fax at 541-774-7979.

Location: 140 S Holly Street, Medford, OR, 97501-3113
person
Provider Profile Details
NPI Number
1841648516
Provider Name
Dustin A Shadley
Credential
Provider Entity Type
Individual
Gender
Male
Address
140 S Holly Street, Medford, OR, 97501-3113
Phone Number
541-774-8201
Fax Number
541-774-7979
Provider Enumeration Date
06/02/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
140 S Holly Street
City
State
Zip
97501-3113
Phone Number
541-774-8201
Fax Number
541-774-7979
person
Provider Business Mailing Address Details
Address
140 S Holly Street
City
State
Zip
97501-3113
Phone Number
541-774-8201
Fax Number
541-774-7979
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
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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