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1043577687
MICHAEL DESCLOUX
PORTLAND, OR
NPI
1043577687
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
163WP0807X Registered Nurse Psychiatric/Mental Health, Child & Adolescent
(Licence: OR 201143647RN)
Enumeration Date
2012-04-20
Last Update Date
2012-04-20
Business Address
MICHAEL DESCLOUX RN
722 NE 162ND AVE
PORTLAND, OR 97230-5760
Phone number: 503-408-5016
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Mailing Address
MICHAEL DESCLOUX RN
21505 NE WILLOW GLEN RD
FAIRVIEW, OR 97024-6793
Phone number: 832-875-5228
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