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1033641782
AMANDA IRIS PROSISE
PORTLAND, OR
NPI
1033641782
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Former Name
AMANDA IRIS TIFENTAL
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2017-03-31
Last Update Date
2017-03-31
Business Address
Mrs. AMANDA IRIS PROSISE
14600 NW CORNELL RD
PORTLAND, OR 97229-5442
Phone number: 503-645-3581
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Mailing Address
Mrs. AMANDA IRIS PROSISE
14600 NW CORNELL RD
PORTLAND, OR 97229-5442
Phone number: 503-645-3581
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