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General NPI Number Information
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NPI Number | 1164097986
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Entity Type | Individual
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Provider Name | MICHAEL RUNNING MS, NCC, LPC INTERN
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Gender | Male
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Dates
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Enumeration Date | 05/24/2021
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Last Update Date | 05/24/2021
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Provider Practice Location Address
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Address Line | 6124 SE MILWAUKIE AVE STE 204
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City | PORTLAND
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State | OR
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Zip | 97202-5347
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Country | US
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Telephone | 503-683-8464
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Fax |
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Provider Business Mailing Address
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Address Line | 3439 SE HAWTHORNE BLVD # 315
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City | PORTLAND
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State | OR
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Zip | 97214-5048
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Country | US
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Telephone | 503-442-3563
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | R6338
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License Number State | OR
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