Marty Ray Boehlke, THW

NPI #1154039584 in Fossil, Oregon

Provider Information

NPI Number: 1154039584
Entity Type: Individual
Name: Marty Ray Boehlke, THW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Peer Specialist
Credential: THW
Enumeration Date: Nov 15, 2022
Last Updated: Nov 15, 2022

Practice Location

Address: 401 FOURTH ST
City: Fossil
State: Oregon
ZIP Code: 97830-8302
Phone: (541) 763-2746

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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