Provider Demographics
NPI:1457115693
Name:FLORES, DEBBY JEAN (PEER SPECIALIST)
Entity Type:Individual
Prefix:
First Name:DEBBY
Middle Name:JEAN
Last Name:FLORES
Suffix:
Gender:F
Credentials:PEER SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4338 MARKET ST NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-2028
Mailing Address - Country:US
Mailing Address - Phone:971-900-6904
Mailing Address - Fax:
Practice Address - Street 1:380 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:STAYTON
Practice Address - State:OR
Practice Address - Zip Code:97383-1855
Practice Address - Country:US
Practice Address - Phone:503-379-2199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR110011175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist