Organization
KAISER PERMANANTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEXANDER SHYBUT B.A. (MILIEU COUNSELOR)
(503) 652-2880
Entity
Organization
Contact information
Practice address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 652-2880
Mailing address
6935 N RICHMOND AVE, PORTLAND, OR 97203-4933
(503) 728-8581
Taxonomy
Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
Primary
—
—
Other
Enumeration date
10/17/2016
Last updated
06/01/2021
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