KIEL JUSTIN TATUM

PORTLAND, OR
NPI1609448521
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: OR  R9212)
Enumeration Date2021-07-12
Last Update Date2026-05-14
Business Address
KIEL JUSTIN TATUM
5441 S MACADAM AVE STE R
PORTLAND, OR 97239-3822
Phone number: 425-678-6463
Mailing Address
KIEL JUSTIN TATUM
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number: