Trista Demarie Boudon

NPI #1740746882 in Seaside, Oregon

Provider Information

NPI Number: 1740746882
Entity Type: Individual
Name: Trista Demarie Boudon
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Peer Specialist
Enumeration Date: Feb 13, 2019
Last Updated: Feb 13, 2019

Practice Location

Address: 318 S HOLLADAY DR
City: Seaside
State: Oregon
ZIP Code: 97138-6728
Phone: (503) 325-0241

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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