Most Relevant Information
Provider Data
| NPI Number: | 1003506429 |
| Provider Name: | CODY M CIMMIYOTTI |
| Entity Type: | Individual |
| Taxonomy Code: | 175T00000X |
| Specialty: | Peer Specialist |
| License Number: | THW000108876 |
Most Important Dates
| Enumeration Date: | 05/09/2023 |
| Last Updated: | 05/09/2023 |
Provider Practice Location
46314 TIMINE WAY
PENDLETON
OR
978019417
Practice Location Phone/Fax
| Phone: | 5419669830 |
| Fax: |
Provider Mailing Location
PO BOX 160
PENDLETON
OR
978010160
Provider Mailing Phone/Fax
| Phone: | 5419669830 |
| Fax: |