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1649973801
MIRA LEE COLLINS
PORTLAND, OR
NPI
1649973801
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
(Licence: OR 108594)
Enumeration Date
2023-03-24
Last Update Date
2023-03-24
Business Address
MIRA LEE COLLINS THW, PSS
3231 SE 50TH AVE # 1831
PORTLAND, OR 97206-2248
Phone number: 503-238-5203
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Mailing Address
MIRA LEE COLLINS THW, PSS
919 NE 47TH AVE APT 4
PORTLAND, OR 97213-2221
Phone number: 503-704-8403
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