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General NPI Number Information
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NPI Number | 1548773963
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Entity Type | Individual
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Provider Name | MARIBEL GUEVARA-MYERS
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Gender | Female
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Dates
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Enumeration Date | 11/07/2017
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Last Update Date | 11/07/2017
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Provider Practice Location Address
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Address Line | 4445 SW BARBUR BLVD
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City | PORTLAND
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State | OR
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Zip | 97239-4047
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Country | US
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Telephone | 503-768-6325
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Fax |
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Provider Business Mailing Address
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Address Line | 12239 SW STEAMBOAT DR
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City | BEAVERTON
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State | OR
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Zip | 97008-7081
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Country | US
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Telephone | 641-328-3690
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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