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1609448521
KIEL JUSTIN TATUM
PORTLAND, OR
NPI
1609448521
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2021-07-12
Last Update Date
2021-07-12
Business Address
KIEL JUSTIN TATUM
1825 NE GLISAN ST
PORTLAND, OR 97232-2844
Phone number: 503-963-7676
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Mailing Address
KIEL JUSTIN TATUM
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number:
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