SHANE ANTHONY GONZALES

PORTLAND, OR
NPI1245065366
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder
Enumeration Date2024-09-06
Last Update Date2024-09-06
Business Address
SHANE ANTHONY GONZALES C.R.M.
1122 NE 122ND AVE STE A200
PORTLAND, OR 97230-2083
Phone number: 503-594-4774
Mailing Address
SHANE ANTHONY GONZALES C.R.M.
1122 NE 122ND AVE STE A200
PORTLAND, OR 97230-2083
Phone number: 503-594-4774
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