Provider Demographics
NPI:1790253698
Name:HUNTAMER, BRIAN MORRIS (CADC I)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:MORRIS
Last Name:HUNTAMER
Suffix:
Gender:M
Credentials:CADC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 NW HARMON BLVD
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-3060
Mailing Address - Country:US
Mailing Address - Phone:541-383-0844
Mailing Address - Fax:541-383-0840
Practice Address - Street 1:601 NW HARMON BLVD
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-3060
Practice Address - Country:US
Practice Address - Phone:541-383-0844
Practice Address - Fax:541-383-0840
Is Sole Proprietor?:No
Enumeration Date:2018-11-08
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor