Individual
CHUOT MUTTHIANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15208 SE TIBBETTS ST, PORTLAND, OR 97236-2356
(503) 760-0959
(503) 761-0041
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(541) 858-8170
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/24/2010
Last updated
10/21/2016
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