Organization
COURAGEOUS ROOTS INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA MILLEN PSYD (CLINICAL PSYCHOLOGIST)
(503) 388-3433
Entity
Organization
Contact information
Practice address
1020 SW TAYLOR ST STE 855, PORTLAND, OR 97205-2570
(503) 388-3433
Mailing address
1020 SW TAYLOR ST STE 855, PORTLAND, OR 97205-2570
(503) 388-3433
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
05/24/2022
Last updated
06/20/2022
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