Individual
MARY KIMA DOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10564 SE WASHINGTON ST, PORTLAND, OR 97216-2809
(971) 806-0587
Mailing address
10564 SE WASHINGTON ST, PORTLAND, OR 97216-2809
(971) 806-0587
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
A12537
OR
Other
Enumeration date
06/28/2021
Last updated
06/28/2021
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