Individual
NATHANIEL LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
209 SW 4TH AVE, PORTLAND, OR 97204-1813
(503) 988-1039
Mailing address
4427 NE 71ST AVE, PORTLAND, OR 97218-3547
(786) 337-2326
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
Primary
C10518
OR
Other
Enumeration date
08/28/2009
Last updated
05/04/2026
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