Individual
AIMEE M POLZIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PRE-CADC,QMHP
Contact information
Practice address
847 NE 19TH AVE, SUITE 100, PORTLAND, OR 97232-2684
(503) 238-0769
(503) 552-6208
Mailing address
1444 SW MAPLECREST DR, PORTLAND, OR 97219
(503) 261-6157
(503) 253-8020
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
C3005
OR
Other
Enumeration date
11/11/2010
Last updated
12/05/2012
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