Individual
MICHELLE NICOLE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, CADCIII
Contact information
Practice address
3550 N INTERSTATE AVE, PORTLAND, OR 97227-1196
(503) 457-4772
Mailing address
500 NE MULTNOMAH ST STE 100, PORTLAND, OR 97232-2099
(800) 813-2000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
19-08-05
OR
101YM0800X
Mental Health Counselor
20-QMHP-R-0145
OR
1041C0700X
Clinical Social Worker
L15955
OR
175T00000X
Peer Specialist
15-CRM-105
OR
175T00000X
Peer Specialist
19-CRM-II-006
OR
Other
Enumeration date
02/23/2016
Last updated
03/12/2026
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