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1083871743
SAM DAVID GILLAM
PORTLAND, OR
NPI
1083871743
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2008-05-20
Last Update Date
2008-05-20
Business Address
-- SAM DAVID GILLAM
2410 SE 121ST AVE
PORTLAND, OR 97216-4066
Phone number: 503-335-5975
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Mailing Address
-- SAM DAVID GILLAM
5815 SW 59TH CT
PORTLAND, OR 97221-1062
Phone number: 503-334-6205
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