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1245864552
MARK WALLACE HONEYWELL SUMMIT
PORTLAND, OR
NPI
1245864552
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: OR 2534)
Enumeration Date
2020-02-25
Last Update Date
2020-02-25
Business Address
MARK WALLACE HONEYWELL SUMMIT LCSW
637 N FARRAGUT ST
PORTLAND, OR 97217-1473
Phone number: 503-715-6298
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Mailing Address
MARK WALLACE HONEYWELL SUMMIT LCSW
637 N FARRAGUT ST
PORTLAND, OR 97217-1473
Phone number: 503-715-6298
Copy
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