Individual
ANGELA BUCKWALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, QMHP
Contact information
Practice address
2476 NW NORTHRUP ST STE 2A, PORTLAND, OR 97210-3133
(971) 319-3244
Mailing address
5040 SE 60TH AVE, PORTLAND, OR 97206-4725
(503) 730-9832
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
05/14/2014
Last updated
01/24/2017
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