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1619354107
CAROL ANNE PROVENCAL
PORTLAND, OR
NPI
1619354107
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2015-05-04
Last Update Date
2015-05-04
Business Address
-- CAROL ANNE PROVENCAL
847 NE 19TH AVE SUITE 100
PORTLAND, OR 97232-2684
Phone number: 503-238-0769
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Mailing Address
-- CAROL ANNE PROVENCAL
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number: 503-238-0769
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