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1013361872
FARA TUCKER
PORTLAND, OR
NPI
1013361872
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: OR 4027)
Enumeration Date
2016-04-19
Last Update Date
2016-04-19
Business Address
-- FARA TUCKER LCSW
6529 NE SANDY BLVD SUITE 101
PORTLAND, OR 97213-4569
Phone number: 503-389-8792
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Mailing Address
-- FARA TUCKER LCSW
6529 NE SANDY BLVD SUITE 101
PORTLAND, OR 97213-4569
Phone number: 503-389-8792
Copy
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