Individual provider · Type 1 NPI

Penny Park

Addiction (Substance Use Disorder) Counselor · Portland, OR

NPI number 1184458762 Active

Practice location

33 NW Broadway
Portland, OR 97209-3580

Call (503) 228-7134 Map

Mailing address

232 NW 6th Ave
Portland, OR 97209-3609

Other practice locations

  • 5019 NE 102nd Ave Unit A, Portland, OR 97220-1199 · (971) 383-1220

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XT-24-4334 (OR)

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

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About NPI 1184458762

Penny Park's National Provider Identifier is 1184458762, issued on Aug 27, 2024. 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 Aug 27, 2024.