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1205911138
PHILIP DEAN ANDERSON
PORTLAND, OR
NPI
1205911138
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR 96-04-02)
Enumeration Date
2006-10-26
Last Update Date
2007-07-12
Business Address
Mr. PHILIP DEAN ANDERSON MS09/10/1952
3325 N INTERSTATE AVE
PORTLAND, OR 97227-1020
Phone number: 503-285-9321
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Mailing Address
Mr. PHILIP DEAN ANDERSON MS09/10/1952
3325 N INTERSTATE AVE
PORTLAND, OR 97227-1020
Phone number: 503-285-9321
Copy
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