Individual
MR. MICHAEL DEAN WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LMT
Contact information
Practice address
343 W POWELL BLVD, GRESHAM, OR 97030-7050
(503) 666-9171
(503) 667-9072
Mailing address
343 W POWELL BLVD, GRESHAM, OR 97030-7050
(503) 666-9171
(503) 667-9072
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
—
174400000X
Specialist
7803
OR
Other
Enumeration date
02/05/2007
Last updated
04/21/2009
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