Provider Demographics
NPI:1245432319
Name:HAYES, AMY D (CADCII)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:D
Last Name:HAYES
Suffix:
Gender:F
Credentials:CADCII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-0025
Mailing Address - Country:US
Mailing Address - Phone:541-278-6330
Mailing Address - Fax:541-278-5419
Practice Address - Street 1:17 SW FRAZER AVE STE 282
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-0048
Practice Address - Country:US
Practice Address - Phone:541-278-6330
Practice Address - Fax:541-278-5419
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR030349101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)