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1679119085
MARK WILLIAM HANSEN
PORTLAND, OR
NPI
1679119085
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2019-11-20
Last Update Date
2019-11-20
Business Address
MARK WILLIAM HANSEN
2600 SE BELMONT ST
PORTLAND, OR 97214-2916
Phone number: 503-239-5738
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Mailing Address
MARK WILLIAM HANSEN
2600 SE BELMONT ST
PORTLAND, OR 97214-2916
Phone number: 503-239-5738
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