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1013784552
JOHN MATTHEW LIVENGOOD
PORTLAND, OR
NPI
1013784552
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Other Name
MATT LIVENGOOD
Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2023-12-05
Last Update Date
2023-12-05
Business Address
JOHN MATTHEW LIVENGOOD
11 NE MLK BLVD STE 203
PORTLAND, OR 97232-3579
Phone number: 971-350-1122
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Mailing Address
JOHN MATTHEW LIVENGOOD
1167 NE 65TH AVE
PORTLAND, OR 97213-4973
Phone number: 503-360-8887
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