Individual
DESTINY MIRANDA VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
333 S FLOWER ST, PORTLAND, OR 97239-3797
(503) 563-8432
(503) 719-8987
Mailing address
333 S FLOWER ST, PORTLAND, OR 97239-3797
(503) 563-8432
(503) 719-8987
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/23/2022
Last updated
08/23/2022
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