Individual
JONATHAN IRVING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6601 NE 78TH CT STE A3, PORTLAND, OR 97218-2823
(503) 252-3949
(503) 252-4027
Mailing address
111 BARKER AVE, OREGON CITY, OR 97045-3421
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/08/2016
Last updated
06/08/2016
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