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Individual

MEGAN KATHLEEN GALLAGHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CADC I

Contact information

Practice address
1949 SE 122ND AVE, PORTLAND, OR 97233-1303
(503) 419-2672
(503) 253-4643
Mailing address
PO BOX 92125, PORTLAND, OR 97292-2125
(503) 419-2672
(503) 253-4643

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13-09-22
OR
171M00000X
Case Manager/Care Coordinator

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13-09-22
ACCBO CADC CERTIFICATION NO.
OR
Enumeration date
08/06/2012
Last updated
02/26/2014
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