Provider Demographics
NPI:1881093375
Name:BAIRD, TRIENA (CADC II)
Entity type:Individual
Prefix:
First Name:TRIENA
Middle Name:
Last Name:BAIRD
Suffix:
Gender:F
Credentials:CADC II
Other - Prefix:
Other - First Name:TRIENA
Other - Middle Name:
Other - Last Name:LINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:PO BOX 17818
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97305-7818
Mailing Address - Country:US
Mailing Address - Phone:503-363-2021
Mailing Address - Fax:
Practice Address - Street 1:465 COMMERCIAL ST NE STE 150
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3414
Practice Address - Country:US
Practice Address - Phone:503-362-2780
Practice Address - Fax:503-362-2768
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR099005166LPN164W00000X
OR12-06-78101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR12-06-78OtherADDICTION COUNSELORS CERTIFICATION BOARD OF OREGON (ACCBO)
OR099005166LPNMedicaid