COLLAINE BROOKE FADDIS

PORTLAND, OR
NPI1184810301
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy174400000X Specialist
(Licence: OR  14317)
Enumeration Date2007-09-20
Last Update Date2007-09-20
Business Address
-- COLLAINE BROOKE FADDIS LMT
4512 SE WOODSTOCK BLVD
PORTLAND, OR 97206-6274
Phone number: 503-777-2776
Mailing Address
-- COLLAINE BROOKE FADDIS LMT
3031 SE 53RD AVE
PORTLAND, OR 97206-2119
Phone number: 503-810-4941
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