Individual
MISS MILES EVAN DORNFELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
722 NE 162ND AVE, PORTLAND, OR 97230-5760
(503) 239-8101
Mailing address
424 NE 22ND AVE, PORTLAND, OR 97232-2809
(541) 231-6159
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/15/2023
Last updated
08/15/2023
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