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1306288568
THOMAS BRUKETTA
PORTLAND, OR
NPI
1306288568
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2013-07-29
Last Update Date
2013-07-29
Business Address
-- THOMAS BRUKETTA
33 NW BROADWAY
PORTLAND, OR 97209-3580
Phone number: 503-228-7134
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Mailing Address
-- THOMAS BRUKETTA
232 NW 6TH AVE
PORTLAND, OR 97209-3609
Phone number:
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