Individual
KIANA PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30 NE MLK JR BLVD, PORTLAND, OR 97232-2941
(503) 232-1099
Mailing address
1806 MARY AUGUSTA ST, MANTECA, CA 95337-8222
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
174400000X
Specialist
Primary
—
—
Other
Enumeration date
03/27/2019
Last updated
05/13/2022
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