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1083175335
NATHAN TUCKER
PORTLAND, OR
NPI
1083175335
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2019-03-28
Last Update Date
2019-03-28
Business Address
NATHAN TUCKER
324 NW DAVIS ST
PORTLAND, OR 97209-3925
Phone number: 503-226-2203
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Mailing Address
NATHAN TUCKER
324 NW DAVIS ST
PORTLAND, OR 97209-3925
Phone number: 503-226-2203
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