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8855 Sw Holly Ln Wilsonville OR 97070-8854 | |
| (503) 970-9042 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 8855 Sw Holly Ln, Wilsonville, Oregon |
| Authorized Official Name and Position | Michelle Miranda (MENTAL HEALTH COUNSELOR) |
| Authorized Official Contact | 5039709042 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
15953 Sw Sunset Ct Sherwood OR 97140-9576 Ph: (503) 970-9042 | 8855 Sw Holly Ln Wilsonville OR 97070-8854 Ph: (503) 970-9042 |
| NPI Number | 1962807529 |
|---|---|
| Provider Enumeration Date | 10/24/2014 |
| Last Update Date | 10/24/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962807529 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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