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1063128916
MITCHELL S BRANCH
PORTLAND, OR
NPI
1063128916
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
261QC1500X Clinic/Center, Community Health
(Licence: OR 22-CRM-1540)
Enumeration Date
2023-01-24
Last Update Date
2023-01-24
Business Address
MITCHELL S BRANCH crm
1817 NE 6TH AVE
PORTLAND, OR 97212-3960
Phone number: 503-719-7985
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Mailing Address
MITCHELL S BRANCH crm
1817 NE 6TH AVE
PORTLAND, OR 97212-3960
Phone number: 503-719-7985
Copy
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