Individual
MR. CHRIS GOFORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
QMHA
Contact information
Practice address
1812 SE MAIN ST, PORTLAND, OR 97214-3889
(503) 963-8337
(503) 963-8365
Mailing address
15606 SE DIVISION ST, PORTLAND, OR 97236-2002
(971) 202-7897
(503) 760-7463
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
171M00000X
OR
Other
Enumeration date
01/30/2007
Last updated
07/14/2023
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