Provider Demographics
NPI:1649604158
Name:DAY, JOHN M (CADC II)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:DAY
Suffix:
Gender:M
Credentials:CADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 STRONG RD SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-9676
Mailing Address - Country:US
Mailing Address - Phone:503-986-0432
Mailing Address - Fax:503-986-0406
Practice Address - Street 1:2450 STRONG RD SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-9676
Practice Address - Country:US
Practice Address - Phone:503-986-0432
Practice Address - Fax:503-986-0406
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR05-11-79101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)