Individual
MR. MYRON J GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
620 NE 2ND ST, GRESHAM, OR 97030
(971) 274-3757
(503) 912-5740
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(503) 224-1044
(503) 621-2235
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L1188
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500646551
—
OR
Enumeration date
06/21/2006
Last updated
10/01/2020
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