Most Relevant Information
Provider Data
| NPI Number: | 1003463357 |
| Provider Name: | IVAN ORTIZ-BUCIO |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/21/2019 |
| Last Updated: | 08/21/2019 |
Provider Practice Location
9320 SW BARBUR BLVD STE 200
PORTLAND
OR
972195499
Practice Location Phone/Fax
| Phone: | 5032229661 |
| Fax: |
Provider Mailing Location
9320 SW BARBUR BLVD STE 200
PORTLAND
OR
972195499
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |