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1205261294
GENETTHIA TASHAWNA GREEN
PORTLAND, OR
NPI
1205261294
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
225400000X Rehabilitation Practitioner
Enumeration Date
2013-09-09
Last Update Date
2015-09-30
Business Address
Ms. GENETTHIA TASHAWNA GREEN
847 NE 19TH AVE SUITE 100
PORTLAND, OR 97232-2684
Phone number: 503-238-0769
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Mailing Address
Ms. GENETTHIA TASHAWNA GREEN
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number:
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