Individual
THERESE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4300 NE FREMONT ST STE 260, PORTLAND, OR 97213-1100
(503) 544-9996
Mailing address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T1370
OR
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
09/04/2014
Last updated
01/25/2024
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