Individual
KRISTOPHER M MCGOWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC II, QMHA
Contact information
Practice address
10700 SW BEAVERTON HILLSDALE HWY STE 11, BEAVERTON, OR 97005-3035
(503) 641-1475
Mailing address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442
(503) 645-3581
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
18-01-36
OR
171M00000X
Case Manager/Care Coordinator
Primary
19-QMHA-I-00870
OR
Other
Enumeration date
10/06/2016
Last updated
05/07/2020
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