WYMAN MACON

PORTLAND, OR
NPI1053060772
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Additional Taxonomies175T00000X Peer Specialist
Enumeration Date2022-03-21
Last Update Date2023-11-29
Business Address
WYMAN MACON
605 SE CESAR E CHAVEZ BLVD
PORTLAND, OR 97214-3216
Phone number: 503-231-7480
Mailing Address
WYMAN MACON
605 SE CESAR E CHAVEZ BLVD
PORTLAND, OR 97214-3216
Phone number: 503-231-7480