Organization
PORTLAND IOP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MILTON PARHAM (EXECUTIVE DIRECTOR)
(509) 668-8008
Entity
Organization
Contact information
Practice address
2675 NW THURMAN ST, PORTLAND, OR 97210-2202
(503) 825-7046
Mailing address
2675 NW THURMAN ST, PORTLAND, OR 97210-2202
(503) 825-7046
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/29/2015
Last updated
01/29/2015
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