Provider Demographics
NPI:1275704751
Name:CLORE, ROBERT (CADC II, NCAC I)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:CLORE
Suffix:
Gender:M
Credentials:CADC II, NCAC I
Other - Prefix:
Other - First Name:BOB
Other - Middle Name:
Other - Last Name:CLORE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CADC II, NCAC I
Mailing Address - Street 1:649 PARKMEADOW LOOP NE
Mailing Address - Street 2:
Mailing Address - City:KEIZER
Mailing Address - State:OR
Mailing Address - Zip Code:97303-7816
Mailing Address - Country:US
Mailing Address - Phone:503-320-2214
Mailing Address - Fax:
Practice Address - Street 1:161 HIGH ST SE STE 225
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3621
Practice Address - Country:US
Practice Address - Phone:503-320-2214
Practice Address - Fax:503-540-7330
Is Sole Proprietor?:No
Enumeration Date:2008-03-12
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)