MICHAEL HENRY LARICCIA

PORTLAND, OR
NPI1033611868
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: OR  21-07-10203)
Enumeration Date2018-03-07
Last Update Date2022-10-05
Business Address
MICHAEL HENRY LARICCIA CADC I
17645 NW SAINT HELENS RD
PORTLAND, OR 97231-1729
Phone number: 503-621-1069
Mailing Address
MICHAEL HENRY LARICCIA CADC I
1776 SW MADISON ST
PORTLAND, OR 97205-1715
Phone number: 503-224-1044
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