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1487125738
JOHN MARK CUSTER
PORTLAND, OR
NPI
1487125738
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: OR 1462)
Enumeration Date
2018-12-16
Last Update Date
2018-12-16
Business Address
JOHN MARK CUSTER LCSW
3550 N INTERSTATE AVE
PORTLAND, OR 97227-1196
Phone number: 503-388-0042
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Mailing Address
JOHN MARK CUSTER LCSW
7224 SW CAPITOL HWY
PORTLAND, OR 97219-2429
Phone number: 503-319-3420
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