Individual
JOHN RAVEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2505 SE 11TH AVE STE 332, PORTLAND, OR 97202-1063
(503) 206-9696
Mailing address
10951 SE STEVENS WAY, HAPPY VALLEY, OR 97086-7435
(503) 206-9696
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10-12-70
OR
101YP2500X
Professional Counselor
C3475
OR
Other
Enumeration date
08/21/2007
Last updated
12/23/2021
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