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Individual

MS. LINDA MARIE CENTURION

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
320 N MAIN AVE STE 201, GRESHAM, OR 97030-7242
(971) 501-3590
(971) 396-9946
Mailing address
PO BOX 86785, PORTLAND, OR 97286-0785
(971) 501-3590
(971) 369-9946

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000WDBCH
MEDICARE
OR
05
164936
OR
Enumeration date
06/13/2008
Last updated
04/16/2021
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