Individual provider · Type 1 NPI

Antonio Lavelle Darshie Martin

Mental Health Counselor · Portland, OR

NPI number 1760020994 Active

Practice location

527 SE Morrison St
Portland, OR 97214-2300

Call (503) 501-5294 Map

Mailing address

8915 SW Center St
Tigard, OR 97223-6307

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1760020994

Antonio Lavelle Darshie Martin's National Provider Identifier is 1760020994, issued on Dec 18, 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 Dec 18, 2019.