Individual provider · Type 1 NPI

Sergey Komarov

Mental Health Counselor · Portland, OR

NPI number 1376199745 Active

Practice location

17710 NE Halsey St
Portland, OR 97230-6734

Call (503) 305-6296 Map

Fax (503) 387-5279

Mailing address

3587 Heathrow Way
Medford, OR 97504-4004

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XPROFESSIONALLICENSE

Mental Health Counselor: Definition to come...

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About NPI 1376199745

Sergey Komarov's National Provider Identifier is 1376199745, issued on Aug 12, 2019. 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 20, 2026.