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1528314614
MATHIAS QUACKENBUSH
PORTLAND, OR
NPI
1528314614
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2012-07-26
Last Update Date
2017-08-15
Business Address
-- MATHIAS QUACKENBUSH MSW
847 NE 19TH AVE
PORTLAND, OR 97232-2684
Phone number: 503-238-0769
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Mailing Address
-- MATHIAS QUACKENBUSH MSW
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number:
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