FEN THOMAS KACIN

PORTLAND, OR
NPI1609671593
Former NameCASSANDRA SOPHIA CLARK
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy175T00000X Peer Specialist
(Licence: OR  113107)
Enumeration Date2025-02-15
Last Update Date2025-02-15
Business Address
FEN THOMAS KACIN PWS
2410 SE 10TH AVE
PORTLAND, OR 97214-4624
Phone number: 503-383-9643
Mailing Address
FEN THOMAS KACIN PWS
2410 SE 10TH AVE
PORTLAND, OR 97214-4624
Phone number: 503-383-9643