ETHAN J NEWCOMB

PORTLAND, OR
NPI1699373324
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy175T00000X Peer Specialist
(Licence: OR  THW000104645)
Enumeration Date2020-10-14
Last Update Date2021-08-26
Business Address
ETHAN J NEWCOMB PSS
1438 SE DIVISION ST
PORTLAND, OR 97202-1140
Phone number: 503-548-0346
Mailing Address
ETHAN J NEWCOMB PSS
1776 SW MADISON ST
PORTLAND, OR 97205-1715
Phone number: 503-224-1044