KEVIN SHANK

PORTLAND, OR
NPI1760867659
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR  17-11-14)
Enumeration Date2015-07-21
Last Update Date2019-11-01
Business Address
KEVIN SHANK
726 W BURNSIDE ST
PORTLAND, OR 97209-3515
Phone number: 503-944-4410
Mailing Address
KEVIN SHANK
10759 SW HERON CIR
BEAVERTON, OR 97007-8353
Phone number:
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