person
Wayne Martin Mallory, CADCI
Addiction (Substance Use Disorder) Counselor in Portland, Oregon
NPI 1881906238

Wayne Martin Mallory is an Addiction (Substance Use Disorder) Counselor based in Portland, OR and is specialized in Addiction (Substance Use Disorder). Wayne Martin Mallory practices in Portland, OR and has the professional credentials of CADCI. The NPI Number for Wayne Martin Mallory is 1881906238 and holds a License No. 09-09-31 (Oregon).

The current practice location address for Wayne Martin Mallory is 16000 Se Powell Blvd Unit 65, Portland, OR and can be reached out via phone at 503-239-5738 and via fax at 503-239-8429.

Location: 16000 Se Powell Blvd Unit 65, Portland, OR, 97236-1783
person
Provider Profile Details
NPI Number
1881906238
Provider Name
Wayne Martin Mallory
Credential
CADCI
Provider Entity Type
Individual
Gender
Male
Address
16000 Se Powell Blvd Unit 65, Portland, OR, 97236-1783
Phone Number
503-239-5738
Fax Number
503-239-8429
Provider Enumeration Date
07/13/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
16000 Se Powell Blvd Unit 65
City
State
Zip
97236-1783
Phone Number
503-239-5738
Fax Number
503-239-8429
person
Provider Business Mailing Address Details
Address
16000 Se Powell Blvd Unit 65
City
State
Zip
97236-1783
Phone Number
503-239-5738
Fax Number
503-239-8429
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
09-09-31 (Oregon)
Definition
Definition to come...
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