Individual
PHYLICIA BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
209 SW 4TH AVE STE 520, PORTLAND, OR 97204-1825
(971) 271-1221
(503) 988-4386
Mailing address
209 SW 4TH AVE STE 520, PORTLAND, OR 97204-1825
(971) 271-1221
(503) 988-4386
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000109546
OR
Other
Enumeration date
09/07/2023
Last updated
09/07/2023
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