Individual
MICHAEL JOHN GODFREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2600 CENTER ST NE, SALEM, OR 97301-2669
(503) 945-9860
Mailing address
2949 SE YAMHILL ST APT 6, PORTLAND, OR 97214-4065
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
L4246
OR
Other
Enumeration date
04/06/2012
Last updated
04/06/2012
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