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1477163657
KEVIN CHARLES REISER
PORTLAND, OR
NPI
1477163657
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR T-20-252)
Enumeration Date
2020-08-03
Last Update Date
2020-08-03
Business Address
KEVIN CHARLES REISER
2318 NE MARTIN LUTHER KING BLVD
PORTLAND, OR 97212-3715
Phone number: 503-335-8611
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Mailing Address
KEVIN CHARLES REISER
2230 SE OAK ST
PORTLAND, OR 97214-1636
Phone number: 716-868-0348
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