Organization
WELLPATH COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEVER NICKERSON LPC (OWNER)
(503) 784-2377
Entity
Organization
Contact information
Practice address
3701 SE MILWAUKIE AVE STE D, PORTLAND, OR 97202-3835
(503) 784-2377
Mailing address
3701 SE MILWAUKIE AVE STE D, PORTLAND, OR 97202-3835
(503) 784-2377
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C3163
OR
Other
Enumeration date
05/10/2018
Last updated
05/10/2018
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