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1174133953
LAURA ANNE PETTIS-CLARK
CLACKAMAS, OR
NPI
1174133953
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2020-08-05
Last Update Date
2020-08-05
Business Address
LAURA ANNE PETTIS-CLARK QMHA-R
12901 SE 97TH AVE STE 340
CLACKAMAS, OR 97015-7903
Phone number: 503-655-8045
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Mailing Address
LAURA ANNE PETTIS-CLARK QMHA-R
2300 NE 165TH DR
PORTLAND, OR 97230-5525
Phone number: 971-285-2476
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