Individual
PAMELA SELF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2415 SE 43RD AVE STE 200, PORTLAND, OR 97206-1671
(503) 238-0705
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
19-04-13
OR
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
L10482
OR
Other
Enumeration date
06/28/2016
Last updated
09/28/2023
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