Individual provider · Type 1 NPI

Jesse C. Staubach

Peer Specialist · Coos Bay, OR

NPI number 1114560802 Active

Practice location

320 Central Ave Ste 304
Coos Bay, OR 97420-2241

Call (541) 366-7640 Map

Mailing address

PO Box 802
Coos Bay, OR 97420-0148

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist Primary 175T00000XTHW000003807 (OR)

Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

5 other providers at this address

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About NPI 1114560802

Jesse C. Staubach's National Provider Identifier is 1114560802, issued on Oct 24, 2019. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Coos Bay, OR. The record was last updated on Oct 24, 2019.