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1194329342
EDDIE MARK MOUNIVONG
PORTLAND, OR
NPI
1194329342
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
Enumeration Date
2020-11-29
Last Update Date
2021-06-16
Business Address
EDDIE MARK MOUNIVONG MSW
3710 SW US VETERANS HOSPITAL RD
PORTLAND, OR 97239-2964
Phone number: 503-220-8262
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Mailing Address
EDDIE MARK MOUNIVONG MSW
3710 SW US VETERANS HOSPITAL RD
PORTLAND, OR 97239-2964
Phone number: 503-220-8262
Copy
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