Individual
AVERYL IRENE GROWDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10373 NE HANCOCK ST, PORTLAND, OR 97220-3873
(503) 238-0769
(503) 552-6208
Mailing address
847 NE 19TH AVE, PORTLAND, OR 97232-2684
(503) 238-0769
(503) 552-6208
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
08-06-27
OR
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
C2988
OR
Other
Enumeration date
03/31/2011
Last updated
01/08/2013
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