Individual
NATHANIEL ALEX PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1750 SW SALMON ST, PORTLAND, OR 97205-1782
(503) 916-5200
Mailing address
1750 SW SALMON ST, PORTLAND, OR 97205-1782
(503) 916-5200
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
152364
OR
Other
Enumeration date
08/21/2025
Last updated
08/21/2025
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