Individual
KOWKIE DURST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
825 NE 20TH AVE STE 250, PORTLAND, OR 97232-2282
(503) 917-5737
Mailing address
5250 NE SKIDMORE ST, PORTLAND, OR 97218-2180
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/20/2025
Last updated
01/20/2025
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