Individual provider · Type 1 NPI

Darartu A. Indissa

Mental Health Counselor · Portland, OR

NPI number 1760151054 Active

Practice location

847 NE 19th Ave
Portland, OR 97232-2684

Mailing address

10905 SW 78th Ave
Portland, OR 97223-8728

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800X27841 (MN)
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1760151054

Darartu A. Indissa's National Provider Identifier is 1760151054, issued on Sep 9, 2021. 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 8, 2022.