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1184487787
NICHOLAS B WAVERS
PORTLAND, OR
NPI
1184487787
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: OR R8909)
Enumeration Date
2024-02-05
Last Update Date
2024-03-13
Business Address
Mr. NICHOLAS B WAVERS PCA
11740 SW 68TH PKWY STE 200
PORTLAND, OR 97223-9058
Phone number: 425-477-4216
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Mailing Address
Mr. NICHOLAS B WAVERS PCA
980 NE ORENCO STATION LOOP APT 621
HILLSBORO, OR 97124-4503
Phone number:
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