Provider Demographics
NPI:1144734229
Name:WRIGHT, GARY E (CADC II)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:E
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:CADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 SW D ST STE D&E
Mailing Address - Street 2:
Mailing Address - City:MADRAS
Mailing Address - State:OR
Mailing Address - Zip Code:97741-1334
Mailing Address - Country:US
Mailing Address - Phone:541-306-2745
Mailing Address - Fax:
Practice Address - Street 1:185 SW D ST STE D&E
Practice Address - Street 2:
Practice Address - City:MADRAS
Practice Address - State:OR
Practice Address - Zip Code:97741-1334
Practice Address - Country:US
Practice Address - Phone:541-410-2752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-28
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15-11-22101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)