Individual
MYRANDA WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PWS
Contact information
Practice address
12360 E BURNSIDE ST, PORTLAND, OR 97233-1042
(971) 279-4800
(971) 279-2051
Mailing address
211 SE CARUTHERS ST, PORTLAND, OR 97214-4502
(509) 224-1044
(971) 260-0355
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000109640
OR
Other
Enumeration date
03/25/2025
Last updated
03/25/2025
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