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1104419027
MIKAYLA SHYANNE LONG
TIGARD, OR
NPI
1104419027
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2021-02-11
Last Update Date
2021-02-11
Business Address
MIKAYLA SHYANNE LONG
8915 SW CENTER ST
TIGARD, OR 97223-6307
Phone number: 503-726-3690
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Mailing Address
MIKAYLA SHYANNE LONG
8691 NE TRAILWALK DR APT B304
BEAVERTON, OR 97006-4954
Phone number:
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