Individual
RAYCHEL LAVONNE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRM
Contact information
Practice address
2901 E BURNSIDE ST, PORTLAND, OR 97214-1831
(503) 238-5203
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(503) 224-1044
(503) 621-2235
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
T-16-046
OR
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/25/2016
Last updated
09/24/2019
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