Individual
MICHAEL SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1949 SE 122ND AVE, PORTLAND, OR 97233-1303
(503) 253-5954
Mailing address
232 NW 6TH AVE, PORTLAND, OR 97209-3609
(503) 294-1681
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
06-03-43
OR
Other
Enumeration date
11/20/2014
Last updated
11/20/2014
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