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Individual

MISS MARTHA MELANIE AMANDA COLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4710 PLOMONDON ST APT 104, VANCOUVER, WA 98661-6188
(503) 995-8947
Mailing address
16141 E BURNSIDE ST, PORTLAND, OR 97233-3519
(503) 252-3949
(503) 252-4027

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
09/06/2012
Last updated
09/06/2012
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