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1114514742
ELLA ILIANA SMITH
PORTLAND, OR
NPI
1114514742
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Other Name
ELLA ILIANA GRANT
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2020-12-29
Last Update Date
2020-12-29
Business Address
ELLA ILIANA SMITH QMHA, CADC I
6025 SE BELMONT ST
PORTLAND, OR 97215-1927
Phone number: 866-262-0531
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Mailing Address
ELLA ILIANA SMITH QMHA, CADC I
6025 SE BELMONT ST
PORTLAND, OR 97215-1927
Phone number: 866-262-0531
Copy
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