Individual
KOREL PONTI-FOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., LMFT, ATR
Contact information
Practice address
5932 NE GLISAN ST, PORTLAND, OR 97213-3754
(503) 956-6133
Mailing address
7831 SE STARK ST, SUITE 202, PORTLAND, OR 97215-2357
(503) 956-6133
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T1102
OR
Other
Enumeration date
12/18/2012
Last updated
10/31/2016
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