RICK LAVERN MATHIESEN

PORTLAND, OR
NPI1588172142
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR  17-11-20)
Enumeration Date2018-01-17
Last Update Date2018-01-17
Business Address
RICK LAVERN MATHIESEN CADC I
10101 SW BARBUR BLVD STE 101
PORTLAND, OR 97219-5915
Phone number: 503-245-6262
Mailing Address
RICK LAVERN MATHIESEN CADC I
10101 SW BARBUR BLVD STE 101
PORTLAND, OR 97219-5915
Phone number: 503-245-6262
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