Individual
MARK OWEN FOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2415 SE 43RD AVE, SUITE 200, PORTLAND, OR 97206-1600
(503) 230-9654
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/08/2013
Last updated
04/08/2013
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