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General NPI Number Information
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NPI Number | 1780907089
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Entity Type | Organization
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Legal Business Name | MICHELE J RUBINO LLC
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Dates
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Enumeration Date | 03/01/2010
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Last Update Date | 03/01/2010
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Provider Practice Location Address
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Address Line | 10490 SW EASTRIDGE ST #130
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City | PORTLAND
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State | OR
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Zip | 97225-5030
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Country | US
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Telephone | 503-292-8466
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Fax | 503-297-2347
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Provider Business Mailing Address
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Address Line | 1827 NW SUNDOWN LN
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City | PORTLAND
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State | OR
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Zip | 97229-4637
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Country | US
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Telephone | 503-292-8466
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Fax | 503-297-2347
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Authorized Official
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Title or Position | OWNER
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Name | MICHELE J RUBINO
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Credential | M.S.
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Telephone | 503-292-8466
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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 | C0516
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License Number State | OR
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