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1467199463
BRIAN FUQUA
PORTLAND, OR
NPI
1467199463
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: OR L7924)
Enumeration Date
2022-05-19
Last Update Date
2022-05-19
Business Address
BRIAN FUQUA LCSW
2382 NW LOVEJOY ST
PORTLAND, OR 97210-3022
Phone number: 503-998-3954
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Mailing Address
BRIAN FUQUA LCSW
2382 NW LOVEJOY ST
PORTLAND, OR 97210-3022
Phone number: 503-998-3954
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