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1033427216
BEN WYATT
PORTLAND, OR
NPI
1033427216
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2010-09-21
Last Update Date
2010-09-21
Business Address
-- BEN WYATT
727 NE 24TH AVE
PORTLAND, OR 97232-2222
Phone number: 503-228-9229
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Mailing Address
-- BEN WYATT
727 NE 24TH AVE
PORTLAND, OR 97232-2222
Phone number:
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