Most Relevant Information
Provider Data
| NPI Number: | 1003234188 |
| Provider Name: | MICHAEL KUBETZ |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | C3288 |
Most Important Dates
| Enumeration Date: | 04/04/2014 |
| Last Updated: | 04/04/2014 |
Provider Practice Location
6864 NE CLAREMONT AVE
PORTLAND
OR
972114042
Practice Location Phone/Fax
| Phone: | 5032414880 |
| Fax: |
Provider Mailing Location
6864 NE CLAREMONT AVE
PORTLAND
OR
972114042
Provider Mailing Phone/Fax
| Phone: | 5032414880 |
| Fax: |