Doctor Name: | TERRY RAY GARCIA |
NPI Number: | 1003117474 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 7525 Se Lake Rd Milwaukie, OR - 972672115 |
Business Phone Number: | 5033034000 |
Business Fax Number: | 5033444412 |
Mailing Address: | Po Box 8459, PORTLAND |
State: | OR |
Postal Code: | 972078459 |
Phone Number: | 5032380769 |
Fax Number: | |
NPI Enumeration Date: | 11/16/2010 |
NPI Last Update Date: | 07/17/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |