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1760720858
KEVIN ANTHONY MICHAELSON
PORTLAND, OR
NPI
1760720858
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2013-01-23
Last Update Date
2015-02-17
Business Address
-- KEVIN ANTHONY MICHAELSON CADC 1
1027 E BURNSIDE ST
PORTLAND, OR 97214-1328
Phone number: 503-236-2290
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Mailing Address
-- KEVIN ANTHONY MICHAELSON CADC 1
1027 E BURNSIDE CODA
PORTLAND, OR 97214
Phone number: 503-236-2290
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