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Contact Information

CHRISTINE A DETROIS
821 SAGINAW ST S
SALEM, OR97302-4121
 Phone: 503-589-4046
 Fax: 503-480-0484
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Case Manager/Care Coordinator

171M00000X
 

Developmental Therapist

222Q00000X
Indicates primary specialty

NPI Profile & details for CHRISTINE A DETROIS · (Female)

NPI Number 1740618982
Status Active
Credentials
Entity Individual
Enumeration date 10/25/2013
Last updated 04/02/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • OR License # 23-QMHA-II-000119
  • OR Medicaid 1740618982
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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