Individual
ERICA AMEZCUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8915 SW CENTER ST, TIGARD, OR 97223-6307
(503) 726-3690
Mailing address
8915 SW CENTER ST, TIGARD, OR 97223-6307
(503) 726-3690
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A378079
ID
OR
Enumeration date
09/28/2021
Last updated
09/28/2021
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