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1306180245
STEPHANIE JEAN WEAVER
GRESHAM, OR
NPI
1306180245
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2012-11-15
Last Update Date
2012-11-15
Business Address
-- STEPHANIE JEAN WEAVER
801 NW WALLULA AVE
GRESHAM, OR 97030-5455
Phone number: 503-726-3740
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Mailing Address
-- STEPHANIE JEAN WEAVER
125 SE 31ST AVE
PORTLAND, OR 97214-1922
Phone number: 503-839-9711
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