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1083073019
JOHN VERVYNCK
PORTLAND, OR
NPI
1083073019
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2016-02-18
Last Update Date
2016-02-18
Business Address
-- JOHN VERVYNCK
2600 SE BELMONT ST
PORTLAND, OR 97214-2916
Phone number: 503-239-5738
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Mailing Address
-- JOHN VERVYNCK
2600 SE BELMONT ST
PORTLAND, OR 97214-2916
Phone number: 503-239-5738
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