Individual
ANN BOUMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2901 E BURNSIDE ST, PORTLAND, OR 97214-1831
(503) 238-5203
Mailing address
6424 NE GOING ST UNIT A, PORTLAND, OR 97218-3138
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/01/2021
Last updated
10/01/2021
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