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1114319241
IRA HAUSAM
HILLSBORO, OR
NPI
1114319241
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2015-02-26
Last Update Date
2015-02-26
Business Address
-- IRA HAUSAM
971 SW WALNUT ST
HILLSBORO, OR 97123-5651
Phone number: 503-640-5297
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Mailing Address
-- IRA HAUSAM
14600 NW CORNELL RD
PORTLAND, OR 97229-5442
Phone number:
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