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1366802126
CODY BLACKBURN
PORTLAND, OR
NPI
1366802126
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2016-03-07
Last Update Date
2016-03-07
Business Address
-- CODY BLACKBURN
6601 NE 78TH CT STE A3
PORTLAND, OR 97218-2823
Phone number: 503-252-3949
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Mailing Address
-- CODY BLACKBURN
6601 NE 78TH CT STE A3
PORTLAND, OR 97218-2823
Phone number: 503-252-3949
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