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Eliasar Diaz Lupean

Counselor, Mental Health in Portland, OR. Individual provider (NPI-1).

NPI number1083170195
StatusActive
Last updated in NPPESFeb 13, 2019

Details

NPI
1083170195
Entity type
Individual (NPI-1)
Name
Eliasar Diaz Lupean
Sex
Male
Sole proprietor
No
Enumeration date
Feb 13, 2019
Last updated
Feb 13, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YM0800X Counselor, Mental Health––Yes

Practice location

9320 Sw Barbur Blvd Ste 200
Portland, OR 97219-5499

Phone 503-222-9661

Mailing address

9320 Sw Barbur Blvd Ste 200
Portland, OR 97219-5499

Phone 503-222-9661

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