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1104554286
CHAZ CHAVON BALKUM
PORTLAND, OR
NPI
1104554286
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2022-08-08
Last Update Date
2022-08-08
Business Address
CHAZ CHAVON BALKUM
7621 N PORTSMOUTH AVE
PORTLAND, OR 97203-5953
Phone number: 503-240-7599
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Mailing Address
CHAZ CHAVON BALKUM
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number:
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