Individual
DEVON BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRM
Contact information
Practice address
10230 SE CHERRY BLOSSOM DR, PORTLAND, OR 97216-2821
(503) 535-1150
Mailing address
10230 SE CHERRY BLOSSOM DR, PORTLAND, OR 97216-2821
(503) 535-1150
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
23-CRM-2172
OR
175T00000X
Peer Specialist
—
—
Other
Enumeration date
11/09/2023
Last updated
11/09/2023
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