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1346780103
OMAR MEDINA
PORTLAND, OR
NPI
1346780103
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR 93-0841022)
Enumeration Date
2017-02-27
Last Update Date
2017-02-27
Business Address
-- OMAR MEDINA BSW, QMHA
6200 SE KING RD
PORTLAND, OR 97222-2891
Phone number: 503-546-6377
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Mailing Address
-- OMAR MEDINA BSW, QMHA
6200 SE KING RD
PORTLAND, OR 97222-2891
Phone number: 503-546-6377
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