NPI 1013627546

John Eric Fordyce

Practitioner Peer Specialist Salem, OR

Practice location

Address: 2045 Silverton Rd NE STE a, Salem, OR 97301-0100
Phone: (593) 588-5358
Fax: (503) 361-2688
Mailing address: 4140 Munkers St SE, Salem, OR 97317-5841

Registered specialties

Peer Specialist Primary

Other Service Providers Taxonomy 175T00000X Licence THW000107123 (OR)

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Registry record

NPI: 1013627546
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Nov 2022
Record last updated: 23 Nov 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.