Individual
CANDACE NICHOLE IRVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1427 SE 182ND AVE, PORTLAND, OR 97233-5008
(503) 761-6006
Mailing address
1027 E BURNSIDE ST, PORTLAND, OR 97214-1328
(503) 239-8400
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
02/15/2024
Last updated
02/15/2024
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