Individual
MICHAEL DAVID RAZAVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPH, CADC I, PRC,
Contact information
Practice address
2054 N VANCOUVER AVE, PORTLAND, OR 97227-1917
(503) 231-8164
Mailing address
2054 N VANCOUVER AVE, PORTLAND, OR 97227-1917
(503) 231-8164
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
11-09-48
OR
175T00000X
Peer Specialist
Primary
15-PRC-004
OR
Other
Enumeration date
09/09/2015
Last updated
09/09/2015
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