Individual
VIVIAN COLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2732 NE BROADWAY ST, PORTLAND, OR 97232-1723
(503) 975-5418
Mailing address
8621 SW 57TH AVE, PORTLAND, OR 97219-3261
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C0408
OR
Other
Enumeration date
12/12/2006
Last updated
07/08/2007
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