Individual provider · Type 1 NPI

Mason Clark Boucher

Mental Health Counselor · Portland, OR

NPI number 1154879781 Active

Practice location

2236 SE Belmont St
Portland, OR 97214-2817

Mailing address

PO Box 8459
Portland, OR 97207-8459

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1154879781

Mason Clark Boucher's National Provider Identifier is 1154879781, issued on Sep 12, 2016. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Portland, OR. The record was last updated on May 15, 2020.