Individual
MR. KEVIN LEE PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC1
Contact information
Practice address
20 NE 10TH AVE, PORTLAND, OR 97232-2916
(503) 239-8400
(503) 239-8407
Mailing address
1027 E BURNSIDE ST, PORTLAND, OR 97214-1328
(503) 239-8400
(503) 239-8407
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
101YA0400X
—
Other
Enumeration date
05/23/2019
Last updated
05/23/2019
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