MICHAEL MANGUM

PORTLAND, OR
NPI1659669638
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2011-07-12
Last Update Date2011-07-12
Business Address
-- MICHAEL MANGUM
4941 NE 17TH AVE
PORTLAND, OR 97211-5709
Phone number: 503-282-3296
Mailing Address
-- MICHAEL MANGUM
14600 NW CORNELL RD
PORTLAND, OR 97229-5442
Phone number: 503-645-3581
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