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Organization

MIKE SIEGEL LPC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICHAEL P SIEGEL JR. MS, MFT, NCC, LPC (SOLE MEMBER)
(503) 381-6453
Entity
Organization

Contact information

Practice address
7409 SW CAPITOL HWY, SUITE 209, PORTLAND, OR 97219-2432
(503) 381-6453
Mailing address
PO BOX 80273, PORTLAND, OR 97280-1273
(503) 381-6453

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C2452
OR

Other

Enumeration date
02/19/2011
Last updated
02/19/2011
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