Individual
DAVID KISTNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
211 NE 18TH AVE, PORTLAND, OR 97232-2822
(971) 248-8899
Mailing address
6336 NE GLISAN ST, PORTLAND, OR 97213-5053
(971) 369-3705
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/19/2024
Last updated
01/19/2024
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