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1205174398
KEVIN ROSS BOONE
PORTLAND, OR
NPI
1205174398
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2013-01-23
Last Update Date
2013-01-23
Business Address
-- KEVIN ROSS BOONE
10373 NE HANCOCK ST SUITE 200
PORTLAND, OR 97220-3873
Phone number: 503-253-6754
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Mailing Address
-- KEVIN ROSS BOONE
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number: 503-238-0769
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