Individual provider · Type 1 NPI

Wyman Macon

Addiction (Substance Use Disorder) Counselor · Portland, OR

NPI number 1053060772 Active

Practice location

605 SE Cesar E Chavez Blvd
Portland, OR 97214-3216

Call (503) 231-7480 Map

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist 175T00000XNone listed
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1053060772

Wyman Macon's National Provider Identifier is 1053060772, issued on Mar 21, 2022. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Portland, OR. The record was last updated on Nov 29, 2023.