RICHARD IVAN VAUGHAN

PORTLAND, OR
NPI1396186607
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children
Enumeration Date2013-07-15
Last Update Date2013-07-15
Business Address
-- RICHARD IVAN VAUGHAN BS
4310 NE KILLINGSWORTH ST
PORTLAND, OR 97208-3007
Phone number: 503-535-1150
Mailing Address
-- RICHARD IVAN VAUGHAN BS
PO BOX 3007 4310 NE KILLINGSWORTH ST
PORTLAND, OR 97208-3007
Phone number: 503-535-1150
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