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1619452307
ETHAN DAVID PETTYJOHN
PORTLAND, OR
NPI
1619452307
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: OR C7752)
Enumeration Date
2018-09-27
Last Update Date
2023-11-13
Business Address
ETHAN DAVID PETTYJOHN LPC
9755 SW BARNES RD
PORTLAND, OR 97225-6651
Phone number: 503-444-4862
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Mailing Address
ETHAN DAVID PETTYJOHN LPC
4370 SW 107TH AVE APT 4
BEAVERTON, OR 97005-3187
Phone number: 978-621-4162
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