Individual
MICHELLE HORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6200 SE KING RD, PORTLAND, OR 97222-2891
(503) 546-6377
Mailing address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
93-0841022
—
OR
Enumeration date
12/12/2017
Last updated
10/02/2019
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