Individual
VANESSA IVY MYERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AAS, CRM
Contact information
Practice address
152 SE 5TH AVE, HILLSBORO, OR 97123-4293
(971) 202-7881
(503) 746-5617
Mailing address
3159 NE 13TH PL, HILLSBORO, OR 97124-4074
(503) 619-7877
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
175T00000X
Peer Specialist
Primary
17-CRM-038
OR
Other
Enumeration date
10/13/2017
Last updated
06/20/2019
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