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Individual

MICHAEL MCCOY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
232 NW 6TH AVE, PORTLAND, OR 97209-3609
(503) 294-1681
Mailing address
232 NW 6TH AVE, PORTLAND, OR 97209-3609

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12-12-40
OR

Other

Enumeration date
04/29/2013
Last updated
04/29/2013
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