Individual
MIMI BARREE BRUCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC R
Contact information
Practice address
211 NE 18TH AVE, PORTLAND, OR 97232-2822
(971) 248-8899
Mailing address
211 NE 18TH AVE, PORTLAND, OR 97232-2822
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-24-4294
OR
Other
Enumeration date
10/25/2024
Last updated
10/25/2024
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