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Individual

MR. JOSE ANTONIO GARCIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
B.S. CADCI QMHA

Contact information

Practice address
9111 NE SUNDERLAND AVE, PORTLAND, OR 97211-1708
(503) 280-6646
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 280-6646

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11-06-28
OR
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
03/18/2008
Last updated
01/15/2014
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