SAM DAVID GILLAM

PORTLAND, OR
NPI1083871743
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101Y00000X Counselor
Enumeration Date2008-05-20
Last Update Date2008-05-20
Business Address
-- SAM DAVID GILLAM
2410 SE 121ST AVE
PORTLAND, OR 97216-4066
Phone number: 503-335-5975
Mailing Address
-- SAM DAVID GILLAM
5815 SW 59TH CT
PORTLAND, OR 97221-1062
Phone number: 503-334-6205