Individual
MIKAYLA AVERY-HULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2740 SE POWELL BLVD STE 5, PORTLAND, OR 97202-2069
(503) 688-2504
Mailing address
1016 SW 27TH CIR, TROUTDALE, OR 97060-1884
(503) 405-0706
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L11839
OR
Other
Enumeration date
08/29/2019
Last updated
08/19/2024
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