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1346513868
DONALD DAVID POLEVACIK
PORTLAND, OR
NPI
1346513868
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2012-02-14
Last Update Date
2012-02-14
Business Address
-- DONALD DAVID POLEVACIK M.S.S.A.
5023 NE KILLINGSWORTH ST
PORTLAND, OR 97218-1915
Phone number: 503-284-4249
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Mailing Address
-- DONALD DAVID POLEVACIK M.S.S.A.
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number: 503-238-0769
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