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General NPI Number Information
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NPI Number | 1629374137
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Entity Type | Individual
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Provider Name | JOSEPH PAUL PANZA MA, LPC, CADC II
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Gender | Male
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Dates
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Enumeration Date | 01/31/2011
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Last Update Date | 12/04/2013
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Provider Practice Location Address
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Address Line | 7817 SW ELMWOOD ST
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City | PORTLAND
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State | OR
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Zip | 97223-9063
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Country | US
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Telephone | 503-333-2037
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Fax | 971-255-0631
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Provider Business Mailing Address
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Address Line | 7817 SW ELMWOOD ST
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City | PORTLAND
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State | OR
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Zip | 97223-9063
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Country | US
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Telephone | 503-333-2037
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Fax | 971-255-0631
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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 | C2358
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License Number State | OR
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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 | 06-R-22
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License Number State | OR
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