TYSCHAL LUMBREA BLAKE

PORTLAND, OR
NPI1427779016
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101Y00000X Counselor
Additional Taxonomies106S00000X Behavior Technician
Enumeration Date2022-09-12
Last Update Date2023-09-18
Business Address
TYSCHAL LUMBREA BLAKE
1904 SE DIVISION ST
PORTLAND, OR 97202-1146
Phone number: 503-517-8663
Mailing Address
TYSCHAL LUMBREA BLAKE
1904 SE DIVISION ST
PORTLAND, OR 97202-1146
Phone number: 503-704-1350