Provider Demographics
NPI:1376332957
Name:DUBENIC, KRISTOPHER D
Entity type:Individual
Prefix:
First Name:KRISTOPHER
Middle Name:D
Last Name:DUBENIC
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 CAVES CAMP RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMS
Mailing Address - State:OR
Mailing Address - Zip Code:97544-9606
Mailing Address - Country:US
Mailing Address - Phone:815-641-6159
Mailing Address - Fax:
Practice Address - Street 1:1201 NE 7TH ST STE D
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-1451
Practice Address - Country:US
Practice Address - Phone:541-281-9026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor