Individual
AUDRA CARMINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
5915 SE 67TH AVE, PORTLAND, OR 97206-5916
(503) 984-0810
Mailing address
5915 SE 67TH AVE, PORTLAND, OR 97206-5916
(503) 984-0810
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
ASSOCIATE
OR
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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