Individual
RYAN SCOTT MCKONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
847 NE 19TH AVE STE 100, PORTLAND, OR 97232-2684
(503) 238-0769
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60895939
WA
372600000X
Adult Companion
—
—
Other
Enumeration date
06/12/2018
Last updated
10/23/2018
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