LEROY G BIGBOY

PORTLAND, OR
NPI1669451332
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR  01-P-03)
Enumeration Date2006-01-11
Last Update Date2017-04-14
Business Address
-- LEROY G BIGBOY CADC I
1631 SW COLUMBIA ST
PORTLAND, OR 97201-6025
Phone number: 503-231-2641
Mailing Address
-- LEROY G BIGBOY CADC I
1776 SW MADISON ST
PORTLAND, OR 97205-1715
Phone number: 971-386-2278
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