Individual
MR. STEPHEN RUSSELL RICHARDSON I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AAEE
Contact information
Practice address
1312 SW WASHINGTON ST, PORTLAND, OR 97205-2327
(503) 535-1150
(503) 535-1191
Mailing address
2046 NW FLANDERS ST, 21, PORTLAND, OR 97209-1159
(503) 804-2520
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/20/2010
Last updated
09/20/2010
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