Individual
MIA LUCA SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW, QMHA
Contact information
Practice address
7621 N PORTSMOUTH AVE, PORTLAND, OR 97203-5953
(503) 240-7599
Mailing address
8041 E BURNSIDE ST, PORTLAND, OR 97215-1548
(503) 252-3304
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/28/2018
Last updated
01/01/2021
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