Individual
TINA MARIE KNAUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC II
Contact information
Practice address
10920 SW BARBUR BLVD, PORTLAND, OR 97219-8600
(503) 244-4500
(503) 244-2008
Mailing address
10920 SW BARBUR BLVD, PORTLAND, OR 97219-8600
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11-R-04
OR
Other
Enumeration date
03/17/2020
Last updated
03/17/2020
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