Individual
MARIAH WARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
411 NE 19TH AVE, PORTLAND, OR 97232-4801
(971) 405-5307
Mailing address
6372 NE CLEVELAND AVE, PORTLAND, OR 97211-2402
(503) 545-8257
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
24-12-11348
OR
Other
Enumeration date
01/27/2025
Last updated
01/27/2025
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