Individual
MR. CHARLES BRYAN HODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MNM
Contact information
Practice address
825 NE 20TH AVE, SUITE 330, PORTLAND, OR 97232-2275
(503) 290-1905
(503) 290-1925
Mailing address
825 NE 20TH AVE, SUITE 330, PORTLAND, OR 97232-2275
(503) 290-1905
(503) 290-1925
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
10/23/2013
Last updated
10/23/2013
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