Individual provider · Type 1 NPI

Donald David Polevacik, M.S.S.A.

Mental Health Counselor · Portland, OR

NPI number 1346513868 Active

Practice location

5023 NE Killingsworth St
Portland, OR 97218-1915

Fax (503) 284-6585

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 1346513868

Donald David Polevacik, M.S.S.A.'s National Provider Identifier is 1346513868, issued on Feb 14, 2012. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Portland, OR. The record was last updated on Feb 14, 2012.