Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Travis Shaddy

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1174449201

Travis Shaddy is an Addiction (Substance Use Disorder) Counselor in Coburg, Oregon. Licensed in Oregon. Registered with an NPI since 2026.

Licensed in
OR
In the registry since
2026

Practice location Address checks out

1 Serenity Ln
Coburg, OR 97408-9350
Phone: (541) 687-1110
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence T-25-6129 (OR)

Record details

NPI number1174449201
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 24, 2026
Last updated in NPPESJune 24, 2026
Certification dateJune 24, 2026
Mailing address1 Serenity Ln, Coburg, OR 97408-9350

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