Individual
MICHAEL RICHARD BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
QMHA
Contact information
Practice address
310 NW FLANDERS ST, PORTLAND, OR 97209-3941
(503) 827-3949
(503) 827-0931
Mailing address
11716 NE 49TH ST APT S2, VANCOUVER, WA 98682-6171
(360) 609-2639
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
01/22/2007
Last updated
09/11/2025
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