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1265997779
KATHRYN DORTHEA FUQUA
PORTLAND, OR
NPI
1265997779
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2019-02-08
Last Update Date
2019-02-08
Business Address
KATHRYN DORTHEA FUQUA
1427 SE 182ND AVE
PORTLAND, OR 97233-5008
Phone number: 503-761-6006
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Mailing Address
KATHRYN DORTHEA FUQUA
1027 E BURNSIDE ST
PORTLAND, OR 97214-1328
Phone number: 503-239-8400
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