Individual
MS. ANGELENE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHA, CPRP
Contact information
Practice address
14600 NW CORNELL RD, PORTLAND, OR 97229
(503) 645-3581
(503) 690-9605
Mailing address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442
(503) 645-3581
(503) 690-9605
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
OR
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
06/15/2018
Last updated
11/15/2018
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