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Individual

MATT FOLSOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.S.W.

Contact information

Practice address
847 NE 19TH AVE, SUITE 100, PORTLAND, OR 97232
(503) 238-0769
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
17-05-20
OR
1041C0700X
Clinical Social Worker
Primary
L7728
OR

Other

Enumeration date
07/13/2015
Last updated
12/29/2021
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