Individual
RILENE ANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHA, CADC I
Contact information
Practice address
5023 NE KILLINGSWORTH ST, PORTLAND, OR 97218-1915
(503) 284-4249
Mailing address
PO BOX 73122, FAIRBANKS, AK 99707-3122
(907) 451-0389
(907) 451-0210
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/06/2007
Last updated
02/08/2021
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