Individual ProviderAveryl Irene GrowdenCounselorBehavioral Health & Social Service ProvidersPractice Address10373 NE Hancock St, Portland, OR 97220-3873(503) 238-0769PECOS EnrollmentBased on the most recent information from CMS, provider Averyl Irene Growden does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1174812051Provider TypeIndividualFull NameGrowden, Averyl IreneGenderFemaleSole ProprietorYesEnumeration Date3/31/2011Last Updated1/8/2013Contact InformationPractice LocationPractice Address10373 NE Hancock St, Portland, OR 97220-3873Phone(503) 238-0769Fax(503) 552-6208Mailing LocationMailing Address847 NE 19th Ave, Portland, OR 97232-2684Phone(503) 238-0769Fax(503) 552-6208Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode101YP2500XDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseC2988OregonCode101YA0400XDescriptionCounselorBehavioral Health & Social Service ProvidersLicense08-06-27Oregon