Individual
DEBRA JEAN KANNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4035 NE SANDY BLVD STE 200, PORTLAND, OR 97212-5331
(971) 940-2601
Mailing address
8827 SE ALDER ST, PORTLAND, OR 97216-1607
(503) 490-6418
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/30/2018
Last updated
11/30/2018
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