Individual
DR. TEREK KANSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D., LPC
Contact information
Practice address
10127 SW 59TH PL, PORTLAND, OR 97219-5708
(503) 866-9688
Mailing address
10127 SW 59TH PL, PORTLAND, OR 97219-5708
(503) 866-9688
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C4721
OR
Other
Enumeration date
05/15/2018
Last updated
05/15/2018
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