MATTHEW DAVID FONTAINE

PORTLAND, OR
NPI1144515289
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy163WP0808X Registered Nurse, Psych/Mental Health
(Licence: OR  201140738RN)
Enumeration Date2011-06-16
Last Update Date2011-06-16
Business Address
-- MATTHEW DAVID FONTAINE AAS
13317 SE POWELL BLVD
PORTLAND, OR 97236-3335
Phone number: 503-760-9606
Mailing Address
-- MATTHEW DAVID FONTAINE AAS
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number: 503-238-0769
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