Individual provider · Type 1 NPI
Edward Frazier Sirchuk Sr.
Peer Specialist · Harbor, OR
NPI number
1851107635
Active
Practice location
15957 Highway 101 S Ste 11
Harbor, OR 97415-8507
Mailing address
General Delivery
Harbor, OR 97415-9999
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| PACE Provider Organization | 251T00000X | None listed |
| Peer Specialist Primary | 175T00000X | None listed |
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.
About NPI 1851107635
Edward Frazier Sirchuk Sr.'s National Provider Identifier is 1851107635, issued on Dec 6, 2024. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Harbor, OR. The record was last updated on Dec 7, 2024.