Individual
SAMUEL ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1631 SW COLUMBIA ST, PORTLAND, OR 97201-6025
(503) 231-2641
Mailing address
5398 SE MALDEN DR, PORTLAND, OR 97206-0880
(605) 730-2746
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/29/2015
Last updated
10/29/2015
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