Individual
SHERRILYNN BLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4134 N VANCOUVER AVE STE 102, PORTLAND, OR 97217-2900
(503) 331-2548
(503) 331-2549
Mailing address
4134 N VANCOUVER AVE STE 102, PORTLAND, OR 97217-2900
(503) 331-2548
(503) 331-2549
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
97-04-08
OR
101YM0800X
Mental Health Counselor
A-2896
OR
Other
Enumeration date
04/18/2014
Last updated
04/18/2014
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