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Individual

MARK WILLIAM FIELDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
QMHP

Contact information

Practice address
11211 SE 82ND AVE STE O, HAPPY VALLEY, OR 97086-7641
(503) 722-6200
(503) 722-6545
Mailing address
11211 SE 82ND AVE STE O, HAPPY VALLEY, OR 97086-7641
(503) 722-6200
(503) 722-6545

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
01/03/2018
Last updated
02/03/2020
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