Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 20-07-33 | OR |
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 61113424 | WA |
NPI | 1003206236 |
---|---|
Provider Name | Miss Melissa Dawn Hill |
First Address | Portland, OR 97232-2023 |
Second Address | Vancouver, WA 98684-6055 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2015 |
Last Update Date | 20/12/2021 |