Individual
PEGGY SURFUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
326 SE 76TH AVE, PORTLAND, OR 97215-1468
(503) 255-3198
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
—
—
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
01/08/2014
Last updated
07/28/2014
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