Individual
TERESA SOULE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
324 NW DAVIS ST, PORTLAND, OR 97209-3925
(503) 226-2203
Mailing address
324 NW DAVIS ST, PORTLAND, OR 97209-3925
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/15/2018
Last updated
06/15/2018
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