Individual
PHILLIP A BROYLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADCII
Contact information
Practice address
3945 SE HAWTHORNE BLVD, PORTLAND, OR 97214-5241
(503) 719-5250
(503) 715-5672
Mailing address
3945 SE HAWTHORNE BLVD, PORTLAND, OR 97214-5241
(503) 719-5250
(503) 715-5672
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
050351
OR
Other
Enumeration date
11/07/2013
Last updated
11/07/2013
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