Individual
SANJAY SOMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442
(503) 645-3581
Mailing address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15-05-31
OR
171M00000X
Case Manager/Care Coordinator
Primary
19-QMHA-I-01590
—
Other
Enumeration date
05/24/2011
Last updated
10/22/2020
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