MICHAEL RICHARD BROCK

PORTLAND, OR
NPI1558415091
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Additional Taxonomies372600000X Adult Companion
Enumeration Date2007-01-22
Last Update Date2007-07-08
Business Address
-- MICHAEL RICHARD BROCK QMHA
310 NW FLANDERS ST
PORTLAND, OR 97209-3941
Phone number: 503-827-3949
Mailing Address
-- MICHAEL RICHARD BROCK QMHA
11716 NE 49TH ST APT S2
VANCOUVER, WA 98682-6171
Phone number: 360-609-2639