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1700258720
SAMUEL ROBERTSON
PORTLAND, OR
NPI
1700258720
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2015-10-29
Last Update Date
2015-10-29
Business Address
-- SAMUEL ROBERTSON
1631 SW COLUMBIA ST
PORTLAND, OR 97201-6025
Phone number: 503-231-2641
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Mailing Address
-- SAMUEL ROBERTSON
5398 SE MALDEN DR
PORTLAND, OR 97206-0880
Phone number: 605-730-2746
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