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1124539879
CLEMENTINE WILSON
PORTLAND, OR
NPI
1124539879
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2017-10-21
Last Update Date
2017-10-21
Business Address
CLEMENTINE WILSON
3415 SE POWELL BLVD
PORTLAND, OR 97202-3371
Phone number: 503-234-9591
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Mailing Address
CLEMENTINE WILSON
3415 SE POWELL BLVD
PORTLAND, OR 97202-3371
Phone number: 503-234-9591
Copy
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