| Teras Interventions And Counseling | |
|
3945 Se Hawthorne Blvd Portland OR 97214-5241 | |
| (503) 719-5250 | |
| Not Available |
| Full Name | Teras Interventions And Counseling |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 3945 Se Hawthorne Blvd, Portland, Oregon |
| Authorized Official Name and Position | Phillip Broyles (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5037195250 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Teras Interventions And Counseling 3945 Se Hawthorne Blvd Portland OR 97214-5241 Ph: (503) 719-5250 | Teras Interventions And Counseling 3945 Se Hawthorne Blvd Portland OR 97214-5241 Ph: (503) 719-5250 |
| NPI Number | 1184917783 |
|---|---|
| Provider Enumeration Date | 05/16/2011 |
| Last Update Date | 11/08/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184917783 | NPI | - | NPPES |
| 500658984 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (Oregon) | Primary |
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