Most Relevant Information
Provider Data
| NPI Number: | 1003658824 |
| Provider Name: | MICHAEL PATRICK TEAGUE CADC-1 |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/11/2024 |
| Last Updated: | 08/24/2024 |
Provider Practice Location
10600 SE MCLOUGHLIN BLVD STE 207
PORTLAND
OR
972227428
Practice Location Phone/Fax
| Phone: | 8446010720 |
| Fax: |
Provider Mailing Location
605 SE CESAR E CHAVEZ BLVD
PORTLAND
OR
972143216
Provider Mailing Phone/Fax
| Phone: | 5032317480 |
| Fax: |