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Individual

DUANE W KOWALSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRM/PSS

Contact information

Practice address
620 NE 2ND ST, GRESHAM, OR 97030-7514
(971) 274-3757
(503) 912-5740
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(503) 224-1044
(503) 621-2235

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16-CRM-207
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
THW000001533
OR

Other

Enumeration date
04/30/2018
Last updated
04/30/2018
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