Individual
FORREST ISRAEL JAMES SLOAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9111 NE SUNDERLAND AVE, PORTLAND, OR 97211-1708
(503) 238-0769
(503) 552-6208
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
(503) 552-6208
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
372600000X
Adult Companion
12-06-53
OR
Other
Enumeration date
03/08/2011
Last updated
12/19/2014
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