Provider Demographics
NPI:1598583031
Name:VARGAS, DANA RUBY (CADC-R)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:RUBY
Last Name:VARGAS
Suffix:
Gender:F
Credentials:CADC-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 N BEAR CREEK RD
Mailing Address - Street 2:
Mailing Address - City:OTIS
Mailing Address - State:OR
Mailing Address - Zip Code:97368-9705
Mailing Address - Country:US
Mailing Address - Phone:541-799-4281
Mailing Address - Fax:888-977-2106
Practice Address - Street 1:3955 SALMON RIVER HWY
Practice Address - Street 2:
Practice Address - City:OTIS
Practice Address - State:OR
Practice Address - Zip Code:97368-9778
Practice Address - Country:US
Practice Address - Phone:541-614-4437
Practice Address - Fax:888-977-2106
Is Sole Proprietor?:No
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT-24-4143101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)