PHILLIP SPENCER BLOMBERG

PORTLAND, OR
NPI1588056964
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR  14-09-01)
Enumeration Date2015-02-23
Last Update Date2015-02-23
Business Address
Mr. PHILLIP SPENCER BLOMBERG CADC-I
18088 SE MARKET
PORTLAND, OR 97233
Phone number: 503-760-1003
Mailing Address
Mr. PHILLIP SPENCER BLOMBERG CADC-I
1027 E. BURNSIDE ST.
PORTLAND, OR 97214
Phone number: 503-239-8400