Individual
MRS. LOREN BETH MICHELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4531 SE BELMONT ST, PORTLAND, OR 97215-1675
(503) 546-9292
Mailing address
4531 SE BELMONT ST, PORTLAND, OR 97215-1675
(503) 546-9292
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
M4848
OR
Other
Enumeration date
01/17/2013
Last updated
01/17/2013
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