Individual
ANGEL T HIRSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PCA/QMHP-C
Contact information
Practice address
12360 E BURNSIDE ST, PORTLAND, OR 97233-1042
(971) 279-4800
(971) 279-2051
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(971) 386-2278
(503) 224-4494
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
R7631
OR
101YM0800X
Mental Health Counselor
19-QMHPC-00185
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500646938
—
OR
Enumeration date
05/21/2012
Last updated
05/21/2024
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