Individual provider · Type 1 NPI

Mandy Clark

Addiction (Substance Use Disorder) Counselor · Portland, OR

NPI number 1316144389 Active

Practice location

1030 NE Couch St.
Portland, OR 97232

Call (503) 239-8400 Map

Fax (503) 239-8407

Mailing address

1027 E. Burnside St.
Portland, OR 97214

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800XNone listed
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

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

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About NPI 1316144389

Mandy Clark's National Provider Identifier is 1316144389, issued on Jul 2, 2007. 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 Feb 20, 2015.