Individual ProviderJonathan ChiaravalleCounselorBehavioral Health & Social Service ProvidersPractice Address502 Washington St Ste 208, The Dalles, OR 97058-2270(541) 705-7045PECOS EnrollmentBased on the most recent information from CMS, provider Jonathan Chiaravalle does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1285067645Provider TypeIndividualFull NameChiaravalle, JonathanCredentialMAGenderMaleSole ProprietorYesEnumeration Date8/20/2013Last Updated1/10/2020Contact InformationPractice LocationPractice Address502 Washington St Ste 208, The Dalles, OR 97058-2270Phone(541) 705-7045Fax(541) 769-0723Mailing LocationMailing Address502 Washington St Ste 208, The Dalles, OR 97058-2270Phone(541) 705-7045Fax(541) 769-0723Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseC4827Oregon